1994, 07-11 Permit App: 94006386 Reroof 9 4 _ 40 3 F-6 , ,
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APPLICATION WORKSHEET 11
L General Information
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1.Job address_L/90 L/ 6 ,23 ref I
Owner
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L Site Information y
Legal Description
"Property size Water District
Number ol: Dwellings Buildings
:Lone
Inspector i goad width
L Project Information 1 )
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�Yermit Use I New I Addition I Re e I Change oI use 1
., L Building Information
Dwelling units Occupant load
Building height Stones
Building dimensions
Total square tootage Req'd parking IHandicap parking Sprinkler system ICnttcalMaterial
Heatin,and insulation information R—values
Square footage breakdown source
Main floor Uncovered/covered deck 'eat
Second Moor Other
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Finished basement
Unfinished basement iiiiMiliiiMMii Milli
Garage
LContractor Information tl
Ytumbwg contractor
Budding contractor
License number Phone
License number Phone
Mailing address
Mailing address
City,state,zip
City,state,zip
Other/Lender 54 s�ru e�� oh
Heating contractorRc F//li6- ! /1 CCS
License number ` Phone
License number Phone RCC€JC' ' U c op 6026 - .3 77
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PROJECT CONTACT I'IIONL'• II
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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REGISTERED AS PROVIDED BY LAW AS A:
CONT .CON <i 1L' . '
REGISTRATION NUMBE R ` fXPlR TION QATE
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ACCEMT kCQN3TRUCI . ;
po.BOX '15261
SPOKANE WA 992155261
SIGNATURE
ISSUED 6+f DEPARTMENT OF LABOR INDUSTRIES