1995, 06-09 Permit App: 95004138 ReroofAPPLICATION INFORMATION
yrs— Nim
What is the JOB SITE address?
ASSESSOR'S tax parcel number?
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Legal description as it appears on the prdperty deed
OWNER or OCCUPANT S
Mailing address
c7 Wen 6-0-V-4_,
Phone
City, state
Zip
Who should we contact regarding this project? Phone
Wi r7 (c7) 89/ e0 /
What work is bein done under this permit?
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CoMractorto g /( :ki n /C�
WA State Contractor license # 7L V
Lo RFA-elfo77/ Uk-
Building height
Thmensions
# of stories
TOTAL SQUARE FOOTAGE
Mailing address
Main floor area
and floor area
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ecUEn ureer ?garage area
Archy g
What is the heat source?
Unfinished basement area
'Finished basement area
What is the cost of your project?
Size of decks, etc.
Manufactured Home
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Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Fire Safety
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
Fuel Storage Tanks
Swimming Pool
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-private
Contractor
Contractor
Wa State Contractor license #
WA State Contractor license*
Mailing address
Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
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