1995, 10-30 Permit App: 95008982 Reroof 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
OWNER or OCCUPANT Phone
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1/1C Co iZG - 1676
Mailing address i City,state Zip
Who should we contact regarding this project? Phone
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What work is being done under this permit?
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Lone ,:Intor district;; '}+roperty size Right of way width
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Wafer distrlat
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Buildin Building height #of stories
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Dimensions TOTAL SQUARE FOOTAGE
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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,�yyour project?
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Manufactured Home Sin
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 Pool
(Circle one) Above-grcurd. underground Sir,r gallons Private
Contents of tanks) Size/gallons
Public/semi-private
Contractor 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.
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