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1992, 04-10 Permit App: 92002393 SewerSpokane County DEPARTMENT OF 'BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET STREET ADDRESS: 5. 2cY C a CITY/STATE/ZIP: 97 /7 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: PHONE: - - MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: P/?/7S7a CONTRACTOR: Cfrn•-dP MAILING ADDRESS: /1-?. /boy /4/24? -2,- /)PHHO : - - cts.S 7 41...,46C-72e/a. irz/ / 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: