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1992, 03-25 Permit App: 92001864 Sewer-V 3 a- Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: Q D- 77499\ /, 777 &717L STREET ADDRESS: (cr CLQ T' CITY/STATE/ZIP: S :71647 -Yl E C_A3A / c SUBDIVISION: t `(�� G Zf L'3 BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: ( # OF DWELLINGS: WATER DISTRICT: OWNER: )=2,-3)„,, PHONE: -- MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: PERMIT USE: REAR: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: PHONE: 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: