1992, 03-16 Permit App: 92001569 Sewera u1f-a•as 9D- Isbl'
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Spokane County 9a— ► s -i o
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DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: S 5 0'F f Y SGL SNA. 'e r
CITY/STATE/ZIP:
aICa - WCk s Lao
SUBDIVISION: Ld o L
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:'11 # OF DWELLINGS: WATER DISTRICT:
OWNER: W I i k 6 ► W` 4- ICunT k 400 Or ev,pHONE: SOS -Sae- a5 d /
MAILING ADDRESS: ,S & vv, -'-e
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
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: