1995, 09-21 Permit App: 95007588 Reroof APPLICATION INFORMATION I5 v
What isthe JOB SITE address? ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
V e-roe.
OWNER or OCCUPANT Phone
Mailing address City,state Zip
9
Who should we contact regarding this project? >� Phone
O\ -2.-
What work is being done under this permit?
(:)S # LOY 1 (40
Lone Inspector district 'Property size Night of way width:
Water district
a
d
Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
Cw�
�
WA State Con`t'ractor license# Main floor area • Unfinished basement area
31 (;' G
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 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 FireSafet
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
�F' ei Stora a g Tasks ; P S�rer�mins
(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.