1989, 10-03 Permit App: 89003776 ReroofSpokane County
DEPARTMENT OF BUILDING & SAFETY
A Division of Public Works
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: 5 • Ho . -a R r
CITY/STATE/ZIP: S. n kWv..r2_J ) A 9 9 a/ a
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: I # OF DWELLINGS: WATER DISTRICT:
OWNER: )'ply -€r+ C . R r0 Lion PHONE: / - 523 9 - g2._5155—
MAILING ADDRESS: S , I (,as L. p
CITY/STATE/ZIP: 0 Mql J A- 9`�� is
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: -2...C) wtil CSG t OSo
CONTRACTOR: R- D1 LAJ hnti (r-enp va_I PHONE: - 3z6— - 6570 of
MAILING ADDRESS: of . A% 867 ¶4j pet t/Cf
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
REQUIRED PARKING:
X (WIDTH X DEPTH) SQ. FT.:
# HANDICAP: SEWER (Y/N): HYDRANT: