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1992, 06-16 Permit App: 92004395 Reroof
Spokane County DEPARTMENT OF BUILDING &SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: /STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: INFORMATION WORKSHEET 3 ((-5- Llk ©,3o BLOCK: L3. LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: 7 -CA\ o-c•Sev\ PHONE: MOM VU -19 - PHONE: 5C q SETBACKS: - FRONT: LEFT: RIGHT: REAR: ERMIT USE:, ,(YD; **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: PHONE: - - MAILING ADDRESS: 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: