1995, 09-14 Permit App: 95007332 Reroof APPLICATION INFOR'NIATION cV . �J3�
\IVhat is the JOB SITE address? ASSESSOR'S tax parcel number? 1
-/ o/ 5 /'e; mss/ � 340 • 0 ( 1 (IL description as it appears on the property deed
65-C-L Le- t
OWNER or OCCUPANT (. - -
Ph ne /
Mailing addressyrfstate Zip
Who should we contact regarding this project? Phone
,/2
LU el� y l / Com/ �sr�3
What work is being done under this permit?
Lone Inspector dlstnct i roperty size Right of way width
H
Water district
is
0
BuildingoimummigionpNinimiiiisoloomenimsm Building height #of stories
Contractor><>:. ...................................._........................._...................,... .
Dimensions 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 Si ni
Width: Length: What is the square footage of • How high is the sign?
the sign face?
Year: Make:
Installer Contractor
We State Contractor license# We 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'Pooh
(Circle one) Above-ground Under round Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license# A 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 programa or activities.