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1990, 11-28 Permit App: 90006425 Fire Damage Repair
Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: / - 170 l STREET ADDRESS: .0 I L ,1 1 \ CITY/STATE/ZIP: y��\/•cine "-&)- SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: OWNER: # OF DWELLINGS: WATER DISTRICT: MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: SETBACKS: - FRONT: PERMIT USE: LEFT: PHONE: RIGHT: REAR: oo *************************************************************** *#*** BUILDING INFORMATION (� CONTRACTOR LICENSE NUMBER: CONTRACTOR: \Ny---LL) ��� (�r�S� PHONE: - L(- yo9(') MAILING ADDRESS: Q.o• c)->ov pc Y LOc„, • (4ga ) ARCHITECT/ENGINEER: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: PHONE: - DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: