1991, 05-21 Permit App: 91002761 MHa.
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
11 -013 -Le,
STREET
1_c13-
STREET ADDRESS:x' /Y / �� /`('-/iDCcUZicc•k �:7.vP� ,Sfc;kIne
CITY/STATE/ZIP: V
(,c. ) A
SUBDIVISION:
BLOCK: LOT: -3 ZONE: J'?- 7 DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH:
R/W:
# OF BUILDINGS: # OF DWELLINGS: f WATER DISTRICT:
OWNER: E 13,c_ I`'( PHONE :7 b � - g 3 � - iD L 0
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT:
PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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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: