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Information Worksheet
Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET STREET ADDRESS: kJ 5 /( FCC ` Reg' e CITY/STATE/ZIP: d �d yo P evG, , R„2,:9 6 SUBDIVISION: BLOCK: LOT: LOT AREA: P/A: ZONE: DISTRICT: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: 0-:;v1 Rte/ 2 7 L 7 _S elo PHONE: 56)(i - 1� - VS -7 MAILING ADDRESS: % c©a Y CITY/STATE/ZIP: � D/ n� �� ?'),.2/2 CONTACT: PHONE : -> O (' SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: ****************************************************k!r#titrtkirrk*ir*ir*.k*.trfkk+tfE*+k*** CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: BUILDING INFORMATION PHONE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING DIMENSIONS: BUILDING HGT: STORIES: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: ( HANDICAP: SPRINKLERED• CRITICAL MATERIAL: