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1992, 03-26 Permit App: 92001916 RemodelSpokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: ( F 3Sj(Y STREET ADDRESS: I e 71odten. CITY/STATE/ZIP: S( 41-91,nmit Wit qq Z ez— SUBDIVISION: 3S' .0T2 BLOCK: LOT: /AND ZONE: DISTRICT: LOT AREA: F/A: WIDTH: 9D,$ / DEPTH: 12c1 R/W: # OF BUILDINGS: a # OF DWELLINGS: / WATER DISTRICT: OWNER: a . A� MAILING ADDRESS: 2•32.1 PHONE: GO ? - 921- ..12-01 CITY/STATE/ZIP: (?AJ'J/div.D 1.0w q`1 Z (s7 CONTACT: PHONE: SETBACKS: - FRONT:3E" LEFT: 15' RIGHT: 2.5 REAR: u 5, PERMIT USE: BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: PHONE: ARCHITECT/ENGINEER: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: PHONE: - BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING:_ # HANDICAP:_ SPRINKLERED:_ CRITICAL MATERIAL: