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1990, 11-28 Permit App: 90006423 Repair Fire DamageSpokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET (Ce543-DII� STREET ADDRESS: CITY/STATE/ZIP: c)012-C`lflE_ j (-pa_ SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: OWNER: MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: # OF DWELLINGS: WATER DISTRICT: PHONE: SETBACKS: - FRONT: PERMIT USE: LEFT: PHONE: RIGHT: REAR: ********************************************************************** CONTRACTOR LICENSE NUMBER: BUILDING INFORMATION -/Jaeoe-Lle-a60k,/,() CONTRACTOR: PHONE: r-SvCi -14B14- 4390 MAILING ADDRESS: �.� `. In l( 1 1 )Th Ln.. f I ARCHITECT/ENGINEER: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: PHONE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: