1995, 07-31 Permit App: 95005812 Tearoff, Reroof ��12
APPLICATION..INFORMATION l\5 -gtgbd
What is the JOB SITE address? A�SESSOR'S tax parcel number?
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Legal description as it appears on the property deed
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OWNER or OCCUPANT r A Phone
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Mailing addressCity,state Zip
11 �cv‘A Ina LL
Who should w!P1tr !t tact regarding this project? Phone I c
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What work is being done this permit?
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Lone Inspector distract <,:property size ," Kight of way width
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Water district -'
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Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
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WA StateL V/`Jh se)IF ��i Main floor area Unfinished basement area
Mailing address -, 2nd floor area Finished basement area
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Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project?
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Manufactured Home Sign
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa 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 Pooi
(Circle one) Above-ground Underground 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
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