1990, 09-17 Permit App: 90004657 Sewer Spokar,e County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET � ^
PARCEL NUMBER: / 6 q-D) - (5721
STREET ADDRESS: N r O�- ski:0 t O Y+L
CITY/STATE/ZIP: ' oma}— y 9 2 to
d� /
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: CA cGG Ke-SSL e_U^- PHONE: - -
MAILING ADDRESS: N. ‘a 51� t„.„),)NT
CITY/STATE/ZIP: S, O kc) e_ 1/40
CONTACT: U 1 k Ab Gl S e.v► PHONE:[a o �/'>- Ufa�/- (G D 7 7
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: 0_,Q14 v7 e. C�,� ,-t
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 3 /2 1C c C - f 0 I k C2
CONTRACTOR: (g/ Co ,$ ru C.D PHONE: .5 v y - - G 0 "7 7
MAILING ADDRESS: E , /0-5- o 4( VQ//prc c-ia/ S p c l-„w - Gc' 7I,2(So
ll J
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: