1996, 04-23 Permit App: 96002725 Reroof , -. t
APPLICATION INFORMATION l D-:�
What is the JOB SITE address? ASSESSOR'S tax parcel number?
T, 7`74>g /ice #176 f 2
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
Oa Ne/-' c-l4--rvt Q=/\,) 1, -. --y&c
Mailing address �City,state Zip
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Who should we contact regarding this project? Phone
What work is being done under this permit?
/7<_ ffeto 7--" S t c -'mac E. — bo(N c, 6v 62 Li°`•-(c-(2___
Lone Inspector dis riot Property size Klght 01 way width
Water district
tz
o m
o
Building
Building height
Contractor
#of stories
Dimensions TOTAL SQUARE FOOTAGE
.} ///' Lith )1' ' T',
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.
L..
What is the heat source? What is the cost of your project?
2/ OO csp
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.