1995, 09-19 Permit App: 95007455 Reroof Ai
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1 APPLICATION INFORMATION
What is e JOB SITE address? ASSESSOR'S tax parcel number?
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Legal_G de,�rraptio it asappears ry'a pr rtY deed �j rr� / _'. /_
OW or OCCUPANTpr) Phone •
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Ma ' . "ddress City,state Zip
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Who shout contact regarding this project? Phone
What work is being done under this permit?
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one• ••••• •••• ••• Inspector distncl Property s¢e Aight of::yvay widttl :;.
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Water district
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Building #of stories
Building height
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Contracto Dimensions TOTAL SQUARE FOOTAGE
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State tractor license# • Unfinished basement area
Mailing ress 2nd floor area Finished basement area
Arc itect/Engineer Garage area Size of decks,etc.
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Whatis the heat so••ce? What is the cost of your proje 5 , C}Cj
Manufac,� red Home S� rr ;
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
i
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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