1992, 08-03 Permit App: 92006002 SewerSpokane County
DEPARTMENT OF BUILDING &SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
STREET ADDRESS: ''
CITY/STATE/ZIP: ' �� K0-4 e I i) C!� 9 � �1�//
INFORMATION WORKSHEET
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SUBDIVISION:
BLOCK:
LOT AREA:
# OF BUILDINGS:
OWNER: -MA- r (
`"MAILING ADDRESS:
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CONTACT:
LOT: ZONE:
F/A: WIDTH:
# OF DWELLINGS:
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DISTRICT:
DEPTH: R/W:
WATER DISTRICT:
PHONE: -_ �- C):3C1 9
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ITY/STATE/ZIP: cv
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SETBACKS: - FRONT:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE:
MAILING ADDRESS:
LEFT:
PHONE: _--- g
RIGHT: REAR:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
NEW: REMODEL:
PHONE:
ADDITION:
DWELL UNITS: OCCUPANT LOAD:
BUILDING DIMENSIONS:
CHANGE OF USE:
BUILDING HGT: STORIES:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: t HANDICAP: SPRINKLERED:, CRITICAL MATERIAL: