1995, 06-27 Permit App: 95004641 Reroof APPLICATION INFORMATION q6 . 1-i (oL4-1
What is the JOB SITE address? ASSESSORS tax parcel number?
/). 060. S r vc9cQ (cWJ
Legal description as it appears on the property deed
( e[rat,mac . /4 C> 135
OWNER or OCCUPANT Phone
vn V -L--rpGai a,�A- 4 Z-, -- 2 tea
Mailing address City,state Zip
. 41 ' S • qq22,C6
Who should we contact regarding is oject? Phone
What work is being done under this ermit?
e Inspector district Yropertysrze Ktght of way width
ar
m
H
Water district:
Y ..: ...
Buildi .
Building height #of storiesn
Contractor Dimensions TOTALS QUARE FOOTAGE
O 145(c-
WA State Contractor license# Main floor area Unfinished basement area
(A-$)(7 `2,e ob tY
Mailing address 2nd floor area Finished basement area
lad S -= Li--
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your proj
MS—
Manufactured Home SSign
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
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in,its programs or activities.