1996, 01-05 Permit App: 96000110 Reroof APPLICATION INFORMATION 9 _ //o
What is the JOB SITE address? ASSESSOR'S tax parcel number?
-., . " O1 1 = 9/- 3-C
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
Ca
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Mailing address City,state Zip
Who should we contact regarding this project? Phone
vers_ o oOQ Lkg-1 tt1-1 I
What work is being done under this permit?
Cone .;: Irtspectordlstr!st i roperty size Right of,way width.«:
d
a)
Water district ;
a,
BuildingBuilding height #of stories
Dimensions TOTAL SQUARE FOOTAGE
WA State Contractor license# Main floor area Unfinished basement area
(In Pt? uL (Z..S v (jvnA
Mailing address 2nd floor area Finished basement area
3(-3 t L4 '4 )V . c.S7 .vvklA`F'(/.
Architect/Engineer Garage area Size of decks,etc.
Whet is the heat source? What is the cost of your project?
Manufactured.Home... :Egiggl ;•>:::»>> i - n ,
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 Flre'Safet
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
Fueltlet Storage Tanks : Swimming Pooi
(Circle one) Above-ground . Underground Size/gallons Private
-Contents of tank(e) ?Size/gallons
IPublic/semi-private
Contractor Contractor
a State Contractor license# A 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.