1996, 04-09 Permit App: 96002255 Reroofm
cn
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APPLICATION
fAPPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
.-8/I E. !U -- - ' ..g.5073/. X113
Legal description as it appears on the property deed
/3-
a
CoaYzren>,
OW(�/N-,E(v(R�-'or�OCCUPANT
Ma ling address
dress
Phone ! 7 2
L5-98 £. [vote -414_2_6,n,
Who shout we contact regarding this project?
Zip
Phone
53!41778 6 -3V --d6-74
What work is being done under this permit?
Contractor
WA State Contractor license #
Building height
Dimensions
Main floor area
# of stories
TOTAL SQUARE FOOTAGE
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? oo
/Zoo -/Sad
Mar (40.00red Herta
Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Rellacat)on
Fir'eSafet
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;Stbtage`Tanks: x
(Circle one) Above -ground Underground
Svirirrlming;iPoo,
O
L
Contents of tank(s)
Size / gallons
Size / gallons
Private
Public/semi-pdvate
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.