1996, 05-10 Permit App: 96003278 Pool APPLICATION INFORMATION
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What is the JOB SITE address? ASSESSOR'S tax parcel number? (-(2 r__
Legal description as it appears on the property deed
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OWNER OCCUPANT Phone
`:�f /i 9 V—x,071
Mailing address City,stat Zip
1+'2/' / 1 Ver-od Q le )011.04 99017
Who should we ortpti regarding this project? 1 Phhyone ,`y/
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What work is being done under this permit?
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Building Building height #of stories
Dimensions TOTALSQUARE FOOTAGE
Corttn�ctor
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 Hot _ 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
F elocution Fire Safety
Previous address Fire Sprinkler Tent _
°' MM Paint booth_ Fire Alarm Fireworks display
VALUE
Contractor . ... . , Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
Feet Storage;Tanks Swimmin Pool
9
(Circle one) Above-ground Underground Sizegallons Private
Contents of tank(s) Size/gallons "' 1 At Da:? 10
00
Public/semi-private
Contractor Contractor ,
Wa State Contractor license# WA State Contractor license# Aved.Ne_T od►/D/
Mailing address Mailing address /j�
O /f'` t�> ,4 4�4i fro e --�f 9kilGh..�' 4AP24g
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.
INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments ❑ Underground utilities
❑ Distances from center of roads, right of ways, ❑ North arrow
private roads & property lines ❑ Septic tanks & wells
0 All existing & proposed buildings