1991, 01-14 Permit App: 91000135 Pellet Stove Spokane County
DEPARTMENT OF BUILDING & SAFETY
A Division of Public Works
INFORMATION WORKSHEET
— X20
PARCEL NUMBER: //
STREET ADDRESS: .34/0 $ S. Si H lode,)
CITY/STATS/SIP: ( (Z,Rd
SIIBDIVIBION:
BLOCK: ,�C LOT: '7 ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: Jap l R/W:
• WATER DISTRICT: J ,� ,G
# OF BUILDINGS: / � OF DWELLINGS. /
OWNER:}kap/4;3 /1/ p ieh / a/7"e-Pri,re- PHONE: I - - ..
MAILING ADDRESS: 34/i 5. Su H/1/p Gd h D1-; ve.-
CITY/STATE/ZIP:.S�✓WI(6,h e , h) j 9,i5e'
ity,th.e)
CONTACT: 2 r,/7 s `/�� 1v/17 i�i'P PHONE: c7) t - �J. - /'l /�
,D ` 7
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: /-�f e P/aij A /2/ A TPL h �P//.y Az,1-04
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: B (WIDTH X DEPTH) SQ. FT. :
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