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1991, 01-16 Permit App: 91000162 Fire Damage Remodel
09007. Spokane County „ sem,, y,, #7o3 qK DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, W4 99260 (509) 456-3675 INFORMATION'WORKSHEET PARCEL NUMBER: /7J,V? - 6,3/Il STREET ADDRESS: / 12 JOG,/%S7" CITY/STATE/ZIP: SUBDIVISION: /Y 6)S3)Lt,-pP)-rlQK- BLOCK: LOT: i� ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: OWNER: # OF DWELLINGS: WATER DISTRICT: MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: /v /Z )4 4: -LT PHONE: - Zy- l0/04? 50a 99 z1z- SETBACKS: - FRONT: PERMIT USE: LEFT: PHONE: RIGHT: REAR: BUILDING INFORMATION yy�,,��^ CONTRACTOR LICCE/N/SE NUMBER: �tS/'� 67 / j l Fj/� I CONTRACTOR: MAILING ADDRESS: ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: - 37(-- 3o6 �• o, Jox 3e552_ K_ ygzzo PHONE: NEW: REMODEL: DWELL UNITS: ADDITION: CHANGE OF USE: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: