1995, 05-15 Permit App: 95003249 MH APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal description as it appears on the property deed
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OWN�"-_ rOCCUPANT /,() ��O Phone
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Mailing address City,state Zip
Who should we contact regarding this project'? Phone
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Wltat work is being done under this permit?
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Inspector< nCt Propertyssize . RIght of waywU tf
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Bulldin Building height #of stories
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ContractorDimensions TOTAL SQUARE FOOTAGE
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
Width: Length: What is the square footage of How high is the sign?
/� 7a the sign face?
Year: %�/CJ c {r
Make:
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Installerst9042...a..,7,--e-
`Contractor
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Wtf State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocation 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 Pool
(Circle one) Above-ground Under round Size/gallons Private
Contents of tank(s) Size/gallons
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.