1995, 08-17 Permit App: 95006403 Pool APPLICATION INFORMATION
What is the JOB SITE address? y ASSESSOR'S tax parcel number?
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Legal des iption as it appears on the property deed
OWNER or OCCUPANT Phone
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Mailing address City,state Zip
__52c2A ah 111/4
Who should we contact regarding this project? Phone
What work is being done under this permit?
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Gone Inspector distnct: Property size Right of wayw idth
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Water district
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Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
WA State Contractor license# Main floor area Unfinished basement area
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 Fir•
e 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/gall ns Private
Contents of tank(s) Size/gallons /6 X32 /
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Contractor Contractor
Wa State Contractor license# WA State ntractor license#
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Mailing address Mailing ad ress
yr'° . / 0(10-, Ste/ 99. 0 y
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.
Site Plan A I°
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INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments 0 Underground utilities
❑ Distances from center of roads, right of ways, 0 North arrow
private roads & property lines 0 Septic tanks & wells
❑ All existing & proposed buildings
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