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1992, 03-24 Permit App: 92001789 Remodel Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 , (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: b6 z/2/ (J- vnJ STREET ADDRESS: 5 • 1/7id2, Y114)-f9b CITY/STATE/ZIP: poK.4a1_, ui cL. 9 9 9.06) SUBDIVISION: P.1 • / O HCl A 0--As2. J ' BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: / # OF DWELLINGS: / WATER DISTRICT: OWNER: '"'W a-- L'o/l eek 4n7 Ce_f PHONE: - 9?g - 7769 MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: 10-gc &adQ2w+a reawtor&V **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: y R'IILLI «9/ a 8 CONTRACTOR: N4 fL r3 ttii,id C mass C--erfo,/ PHONE: - 5-3$/- 22(97 MAILING ADDRESS: ft)* 11-3 57 c" Sed, LAD 97.2 o 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: