1996, 01-23 Permit App: 96000410 Safety Inspect i
APPLICATIQN INFORMATIONc,\ 42,47 . i O
What is the JOB SITE address? ASSESSOR'S tax parcel number?
9/ , / G") `.. D iC/4-,L)L
Legal description as it appears on the propert/i dee(
OWNER or OCCUPANT l,, ----/ 02y _�_ ( Phone
,mss . /, 7// 4-77 / �t��)a 99 9e)9
a address \City,state Zip
9/ ,E, / °-7ti ,dk.-9/t. – L0c"/11, 99..2/ ,
Who should we contact regarding this project? Phone
i1i4 /, / ��' (,, d9) 99 -29e, 9
What work is being done under this permit?
0 e c_.
Lone t:spector rstrict: trroperty size: Hight of way width
a)
Water district....
a :::.:.. ;:<... 0
Buildin Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
WA State Contractor license# Main floor area 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?
Manufactured Hornn Si9
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 dispiay
VALUE
Contractor Contractor
A State Contractor license# WA State Contractor license#
Mailing address Mailing address
Fuel.Storage Tranks •...•...-.-.-•••.-„.•-•••••••••••••.....,.....•-•••-•---.---
wimming 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