1995, 09-11 Permit App: 95007131 Reroof �— l / .
APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR' tax parcel number?
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E.,,
Legal descripti• as it apdears on the property deed
OWNER or OCCUP NT p 4 Phone —
Mailingalddr�Ess CV,state 7 2-(6/1—(0'3 g?-- Zip /
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Who should we contact regarding this project? hone
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What work ieing do - untie"this permit?
7e
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done ;;In •r district: J Property;size Right of way width
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Water district .:..
Buildin Building height #of stories
Contra-tor i Dimensions TOTAL SQUARE FOOTAGE
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WA St to Contractor license# 1' Main floor area Unfinished basement area
A7 )2 z -
Mailing a dress 2nd floor area Finished basement area
/94Q C, Pm_e
Arc dect/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 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
FuelStorage;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.