1995, 09-14 Permit App: 95007313 Re-Roof APPLICA T Iu1J INFORMATION ._ --- 73 '-3
%What is the JOB SITE address? %� 'ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
OWNER Tor CUPAN Phone
w1
Mailing address City,state Zip
t,i), - 9 2P 3
Who should we contact rega i this project? fi Phone
(moi 1 l� - ��.� .
hat workis being one under this pe mit?
Lore"e_— v N a- �' 4 -ec:A-c.i)A- by ,
n't Spector stack::: Property size : Right of way width
d C)
Water district:;
a
a�
0
Building Building
height
g t #of stories
B n hei h
Contractor;;>;:.. .... ......
VYW -J
Dimensions TOTAL SQUARE FOOTAGE
(L�
WA Statrr G�ontractor lice e# 'n Main floor area Unfinished basement area
Mailing address' � 2nd floor area Finished basement area
1,\ i —7 to nity-_A-( t
Arc itect/ ngineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project?
Manufactured Home
S:gn
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.Safet
Y
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
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