1995, 08-03 Permit App: 95005945 Reroof a ...,
APPLICATION INFORMATION
What is the B SITE address? ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
OWNie7 or OCCUPANT Phone
elr /(1/ /sc2,6-\
Mailing a r City,state Zip
Who should ye contact rding this project? Phone
30.2Cu l
What work isbeing don�er this permit?
Gane Inspector dtstnct Property.size Right of way width
N
O
>; y
Water district
a
a�
Building Building height #of stories
Contractor /,.,,,, -.. Dimensions TOTAL SQUARE FOOTAGE
A e Contractor license# / Main floor area Unfinished basement area
� A. /0 asF
i ing address j j� - �4' 1 2nd floor area Finished basement area
Archit�t/Engineer !/ Garage area Size of decks,etc.
What is the heat source? What is the cost of your project7p 2)0 -.
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.