1995, 06-08 Permit App: 95004078 MH t
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APPLICATION INFORMATION 1 7 C )g
What is the JOB SITE address? ,, ASSESSOR'Sr.
tax parcel number?
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Legal description as it appears on the ��opert
OWNER or OCCUPANT Phone
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Mailing address City state Zip
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Who should we contact regarding this project/ Phone
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What work is being done under this permit?
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4cne inspector district; ..... :.:: .. property;size Right of way wI to
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Water district
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Buildin� . .... .... . . . ... ... Building height #of stories
.. .. TOTALS SQUARE FOOTAGE
Contractor:::.:. Dimensions Q •
WA State Contractor license# Main floor area Unfinished basement area
•
Mailing address 2nd floor area Finished basement area
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project?
Manufactured Home ::: Sign
....................... . .
Width: Length: What is the square footage of How high is the sign?
2C • e .� (?S1- the sign face?
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Year:q Make:
I cG \''v(t I kcr etc
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocatiion Fire :Safety
Previous address Fire Sprinkler _ Tent
Paint booth_ Fire Alarm _ Fireworks display _
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
(Fuel Storage Tanks Swimming Poo ;;�
(Circle one) Above-ground Under round
Contents of tank(s)
Contractor
Size/gallons Private
Size/gallons
Public/semi-private
Contractor
a 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.