1995, 10-10 Permit App 95008267 Re-RoofAPPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
Legal description as it appears on the property deed
OWNER or OCCUPANT
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9-?/- rdz
Mailing address City, state Zip
9 7 0 Cvo Side s C'�-) S/o/6, e ity/% t �R
Who should we contact regarding this project?
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6,? v — ,3 0 6 7
What work is being done under thi permit?
/ P p CK s' /tefjo
B
ilding,;
Building height
# of stories
Contractor
/%/6- /DOec/.f/e �" O
Dimensions
TOTAL SQUARE FOOTAGE
WA State Contractor license #
L,09N.-,k 066,0T
Main floor area
Unfinished basement area
Mailing address
Go S . res?-
2nd floor area
Finished basement area
Architect/Engineer
Garage area
Size of decks, etc.
What is the heat source?
Wha is the cost of your project?
/g000 o°
Manufactured Home
Sign r;
Width:
Length:
What is the square footage of
the sign face?
How high is the sign?
Year:
Make:
Installer
Contractor
Wa State Contractor license #
Wa State Contractor license #
Mailing address
Mailing address
Relocation
Fire Safety
Previous address
Fire Sprinkler
Paint booth _ Fire Alarm
Tent
Fireworks display _
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
H
O.
d
0
Mailing address
Mailing address
Fuel Storage Tanks
Swimming Pool
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
Size / gallons
Private
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.
Site Plan
INCLUDE THE FOLLOWING:
❑ All roadways, driveways & easments
❑ Distances from center of roads, right of ways,
private roads & property lines
O All existing & proposed buildings
❑ Underground utilities
❑ North arrow
0 Septic tanks & wells