1995, 10-28 Permit App: 95008848 Re-Roof APPLICATION INFORMATION
What is the JOB SITE address? _ L ASSESSOR'S tax parcel number?
;:= 71q / 0Th
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
TO DO
alhAn
Mailing address City,state Zip
7711#' 6 I Dfh 5 po, ?,2°
Who should we contact regarding this project? Phone
j e 3a4._ k50nl 7 3 7 4
What work is being done under this permit?
Re kloor
Lone Inspector dhstnct',• Property size Right Of way width
N s)
g
Water district;
Y Y
a a
Building 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? Whatis the cost of your project?
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.