1991, 05-16 Permit App: 91002627 RemodelSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
ZSiSvJ - D 2/D
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
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BLOCK: 9 LOT: /d ZONE: DISTRICT:
LOT AREA: F/A:
WIDTH: DEPTH: R/W:
# OF BUILDINGS: 1 # OF DWELLINGS: ` WATER DISTRICT: V ,t,c),
OWNER: «_, A cx \r, SSS M U.
MAILING ADDRESS:��
CITY/STATE/ZIP:
PHONE: 5C `1 _�(�a - 3C)
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: S N T GC_, ' C) `` (:`
CONTRACTOR:
PHONE: 5 b cam- Ltd$ - 0
MAILING ADDRESS: \---nc) ef)i��(Ale_y\ G V)31rA
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: $ ADDITION: CHANGE OF USE:
DWELL UNITS: ( OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X Lk O (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: