1995, 07-24 Permit App: 95005541 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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Mailing address City,state Zip
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Who should we contact regarding this project? Phone
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What work is being done under this permit?
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Gone Inspector dlstnc.t #'roperty:size Right ofway width
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Water district
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Building Building height #of stories
Contractor:;:.;.;............................................................................................:.;:;: Dimensions TOTAL SQUARE FOOTAGE
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WA State Contractor license# Main floor area Unfinished basement area
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Mailing address 2nd floor area Finished basement area
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Ar ect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your prOct QC,ae5a
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.