1995, 06-27 Permit App: 95004640 Reroof APPLICATION INFORMATION C16 - /C/ t
What is the JOB SITE address? ASSESSOR'S tax parcel number?
i 3 7o? i31 ' —
Legal description as it appears on the property deed
OWNER or OCCUPANT Phone
VI \� �� b 0 q — zi- teP
Mailing address City,state Zip
SRC 5 b . qqZ-)k
Who should contact r ardi is project? Phone
Ct . 2--q306 7
What work is being don der this permit?
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Gone Inspector dtstnct Property size Night of way width '
d
H : CO
Water district
a a
d m
Building Building height #of stories
Contractors TOTAL SQUARE FOOTAGE
40 > ► C .
WA State Contrac ' enMain floor area Unfinished basement area
'‘ ' ' i--74-(__.-ke 9 6 bi---
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 ofour project?
I- 2
4 '.
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
ntents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
a 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.