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1992, 05-04 Permit App: 92003063 Sewer
lr' C.-�©co- Spokane County DEPARTMENT OF BUILDING &SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET STREET ADDRESS: ,� , / � 7°)N �t' / e CITY/STATE/ZIP: :24' e, 7 2.41/ 7 2 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: J-/ Cc J/ 74,94 PHONE: % - - j MAILING ADDRESS: /oZ 74=, CITY/STATE/ZIP: CONTACT: C .moi- / /� ( - /71,1 PHONE: ` C 7-��? '- GPS S SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENE CONTRACTOR: MAILING ADDRESS: ARCHITECT/ENGINE: MAILING ADDRESS: at -75(4-0_ )NE: ONE: IMO 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: