1996, 07-15 Permit App: 96005468 Reroof )(1 P //
/ APPLICATION INFORMATION
�Vhat is the JOB SITE address? tie_ ���' I I�X.I,ASSESSOR'S��c�number?
- /4.l1/ ' U^L
Legal description as it appears on the property deed
O7n-�R or OCCUPANT Phone
e��- Fr:
n — 9 Z/ /
Mailing address City,state Zip
Who ho Id we contact regarding this project? Phone
What work is being done under this permit?
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Longi .. i.: ; <: Inspector district < Property size :: M(Ight of way width= ::
� b
4
Water district
a a
d a)
Building Building height #of stories
in
Contractor Dimensions TOTAL SQUARE FOOTAGE
-----\V c C o,c cv Q v(
WA State Contractor license# Main floor area Unfinished basement area
--c c,r cl Y1-1.
Mailing address 2nd floor area Finished basement area
g,5- 1b F_ . Ms ,--( 2_dkc)rt
Architect/Engineer; Garage area Size of decks,etc.
VVhat is the heat source? What is the cost of your project? / /lam
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.