1996, 01-05 Permit App 96000107 Re-RoofC!�i
/07 APPLICATION INFORMATION--52)*5 7a
What is the JOB SITE address?
4,
d
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ASSESSOR'S tax arcel number?
ip
Legal description as it appears on the property deed
7744
02.3,3 y
OWNER or OCCUPANT
9 r^ ;\
Phone
_ L^
Mailing address "
City, state
Zip
Who should we contact regarding this project'?
Phone
What work is being done under this permit?
.................
Contractor
yr% 1 t `J cti L `C�c
WA State Contractor license #
Building height
Dimensions
Main floor area
# of stories
TOTAL SQUARE FOOTAGE
Unfinished basement area
Mailing address
�L'tlk ��-• Lni•LL•-
Architect/Engineer
2nd floor area
Garage area
Finished basement area
Size of decks, etc.
What is the heat source?
What is the cost of your project?
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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
Relo:catior
FreSafei
Previous address
Fire Sprinkler
Paint booth _ Fire Alarm _
Tent
Fireworks display
VALUE
Contractor
Contractor
WA State Contractor license #
WA State Contractor license #
Mailing address
Mailing address
orA9
(Circle one) Above -ground Underground
Contents of tank(s)
Size / gallons
7Vlmmin
Size / gallons
Private
Public/semi-privat
Contractor
Contractor
a State Contractor license #
A 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.
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