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1991, 08-02 Permit App: 91004712 Remodel
Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS:- CITY/STATE/ZIP: DDRESS: CITY/STATE/ZIP: SUBDIVISION: "9L) 6L BLOCK:__ LOT: ZONE: LOT AREA: F/A: WIDTH: # OF BUILDINGS: # OF DWELLINGS: OWNER: CYO, - 4— L jC'�I 4- Pr % MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: DISTRICT: DEPTH: R/W: WATER DISTRICT: PHONE: - q 2 - () PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: U�!R S rc-^ BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: S L�.5 Pct � c���u <, �� PHONE: rjU�( - '2 - 6 "e MAILING ADDRESS:l6 0, 4 L �YJ �71�' 1 c U •e k, (J�,L ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: - - 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: