1990, 08-23 Permit App: 90004132 ReroofSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) .456-3675
INFORMATION 'WORKSHEET
PARCEL NUMBER: a5O
STREET ADDRESS:
CITY/STATE/ZIP: {?m k<L1.1/L
SUBDIVISION:
(L t cic.iOa'`1
BLOCK: LOT:
ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: La -1A 1(`e-, f V1 CY e..Y1 SCS 1(1 PHONE: D �J - 7 6 X F/ )
MAILING ADDRESS:_____
CITY/STATE/ZIP: eZ (Fp A(6, IA p
CONTACT : 00 1() ChaINkb p y. s
Oma. C'7
PHONE: 5 al? - %Y 'l -- "J 3 S'
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: 12...02$15.c..1 VK.aWYilL: / 500 _42-°
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: FJCT E R O i Co Oa --3
CONTRACTOR:
;4.4-e 1i' l D Y� 5 1 v� � � • PHONE: x'09 - /747 -
MAILING ADDRESS: (` g / a 5 , (1/1 . .� � YI L.., OA- .9qc ,
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: