1995, 11-21 Permit App: 95009795 Tear Off, Reroof APPLICATION INFORMATION
— What is the JOB SITE address? ASSESSORS tax parcel number?
13 30 3 . L,) i 4k (.921b)
Legal description as it appears on the property deed
I 1. 1 U 'WA f4o' er 92 4 ' /. 9 7
OWN or OCCUPANT Phone
13 0 3 E . i Lk___ o ,tie.. I�t�a `t`l zJb
i Mailing address Cit),state Zip
/ZOO. cr IVA,()V1,eka v,\VAe.X' �I�3 . 5�z��
Who should we contact regarding this project? Phone
IWhat work is being done under this permit?
TetIr otc ' k_e-`' V r"°J
`._
Lone Inspector district .. Property size Right of way width
d
y N
Water district
0. a
Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
u Cip,nir nL4 i vt C o
WA State Contractor license# ) Main floor area Unfinished basement area
-714. co IJ lit ..3 1 L
Mailing address 2nd floor area Finished basement area
• 53 e_ ;e 5t 1.947
Architect/Engineer t Garage area Size of decks,etc.
What is the heat source? What is the cost of our project?
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 Pool
(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
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in,its programs or activities.