1991, 10-07 Permit App: 91006603 ReroofSpokane County
DEPARTMENT OF BUILDING & SAFETY sg
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: - 11104 a lB .L e.,,
CITY/STATE/ZIP: K t- D I c9 9 2.d (p
SUBDIVISION: UG Lt/? i h)_
BLOCK: LOT: C ZONE: DISTRICT:
LOT AREA: .'F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
OWNER:
# OF DWELLINGS: WATER DISTRICT:
CimIc..LAL � 3iVL
MAILING ADDRESS:
CITY/STATE/ZIP:
PHONE: 6.0-942101- 6)o239
.6)o e- 1 LA) IR 010\ n e
CONTACT: Dan Chambers
PHONE: (509)
747 - 7335
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: (e_rezeic T '6
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: EXTERD*160J3
CONTRACTOR: Exterior Design Company
PHONE: (509) _ 747 - 7335
MAILING ADDRESS: 1816 South Maple Blvd. Spokane, WA 99,203
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT:.. STORIES:
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING:
# HANDICAP: SPRINKLERED: ..CRITICAL MATERIAL: