1995, 04-12 Permit App: 95002261 Reroof APPLICATION INFORMATION � 1
What is the JOB SITE address? ASSESSOR'S tax parcel number?
/°7/4/!l vZ� V ^c. � (`� ! O'`7 '74r 2.. 21 o7
Legal description as it appears on the property deed
( � � i?
OWNER or OCCUPANT Phone
-73 cf. r. �e - . -e—� /��— 965
Mailing address City,state Zip
5cc-VV)€._
Who should we contact regarding this project? Phone
What work is being one under this permit?
;Ct,6-,{,C CtUkl:,(_0' c / 2 2, 3 3
Lone Inspector district Property size Right of way width c<
5) s)
U) v)
D
Water district
a a
CD 5)
0
Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
i(j)/(fVU)-"`
WA State Contractor lice se# 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 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.