1995, 09-27 Permit App: 95007755 Reroof APPLICATION INFORMATION
'What is the JOB SITE address? ASSESSOR'S tax parcel number?
/5.— 1 F', �'� lG &)A 19,20 1/ 7
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
Rosy KASf)A22— I ( <f
Mailing address City,state Zip
iT /67774 5Pd1, f t'.c1At c)99.,d
Who should we contact regarding this project? / Phone
What work is being done under this permit?
Lone .;> ..... Inspector district Property:;¢e . .:,. R..Ight at way.width;
a� m
y f N
Water district
.J
a a
a� ;: at
O 0
Building Building g heih g t _ #of stories
Contractor simensions O A SQU• ' •r•
ft1Z CoAlSTeueTaA ST r /Ate_
WA State Contractor license# Main floor area Unfinished basement area
Mailing a dress 2nd floor area Finished basement area
( 0/7 AZ �tA)1•4 5 KWE 4), 960
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project?z??^ CYQ 4--//_
•
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 Safet
Y
Previous address Fire Sprinkler Tent _
Paint booth Fire Alarm Fireworks display _
it
VALUE
Contractor 'Contractor
WA State Contractor license# A State Contractor license#
Mailing address Mailing address
Fuel Storage Tanks (Swimming"PooLl
(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.