1994, 06-08 Permit App: 94005263 MHII
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APPLICATION WORKSHEET
General Information
V [1 7%O elate Plegr (grwk UI L)hoTS 4
Site Information
4s C
Phone
S4s_ -6,E) 4'o
X90)7
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Legal Description
Properly size
Water District
Number or:
Liweflings Biaddtnga
':Gone ^:
Inspector. • •
Road width
L Project Information 1
ye- 1q9i-le
Wba--
rPlrie/vtQ14+cu.e.
New,
A-aditton
Remodel
Building Information
Change of use I
r e tng units
a upant oa ,
t ut . ing eig t
Second floor
tones
I-rnuhea basemen)
t.
Building dimensions
ti
I oral sgture footage
Req'd parking
1 Handicap parking
SpnnUer system
I CnticalMatena1
II
�glure footage breakdown
Main floor
Uncovered /covered deck
Second floor
Other
I-rnuhea basemen)
License nutnber
Malting address
UnT ntihabasement
ikilliWrddiess
Garage
City. state, rip
Contractor Information
HeaIui. and inautation information R-valnea
eat source
11.111111.111M
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License number
Phone
Budding contractorum
tnT�6 g o rx or
License number
Phone
License nutnber
Malting address
Phone
ikilliWrddiess
City. state, rip
City, state, zip
'leafing contractor
Other! Lcnder
"License number
' one
.icense number
Phone
':raU a'ddrei
aiaril-dalress
'City. stair. rip
City, state, zip
PItOlt.t-t' (Y)NTACF'
PI ION1
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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