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1990, 08-21 Permit App: 90004074 Sewer
Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: J Lf '-62/3Z STREET ADDRESS: t • it / ✓L /4 -UV K 4-Ve- CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: /L( / 7741 --ems PHONE: <09 - 92-2- - O o 2 - MAILING MAILING ADDRESS: S #44vta & ,4- A/3o is CITY/STATE/ZIP: 5 9:0 C4-A4t tAr ¢ / 9 9 2 - CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: PHONE: 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: