1994, 09-02 Permit App 94008450 Tree Damage111
[ General Information
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APPLICATION WORKSHEET
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Tla itlm-�dress
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City
Site Information
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Legal Description
Phon,
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Property size
Water District
Zone
Inspector
Number or:
Road width
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Project Information
Permt Use '
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Building Information
New {Addition
Remodel 1 Change of use
Dwelling units
Occupant Toad
Building height
Stones
Building dimensions
rota! square footage
Req'd parking
f Handicap parking
Spnnkier system
I Ord Ica IMaterial
SgImre rootage breakdown
Mn Iloor
Uncovered /covered deck
Second Iloor
Other
Finished basement
Unfinished basement
Cia rage
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Contractor Information
Heatin, and imitation information R-values
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oogra•e
fiance e icency
jiudding contractor
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Plumbing contractor
License number phone
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Licence number
Phone
Mailing address
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Mailing address
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Heating contractor
Other / Leader
License number Phone
License number
Phone
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Mailing address
City, state, zip
-Cily, state. zip
PROJECT CONTACT
PHONE
Spokane County Division of Buildings
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DEPARTMENT OF LABOR AND INDUSTRIES
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
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REGISTRATION NUMBER
EXPIRATION DATE
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10 /07/y4
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04/17/t7
TiMLINSON`CONST3i,C1ION 18C"
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a'OKANE
GA
99 20 7.
STATE OF WASHINGTON
F625-052-000 (: