1991, 05-13 Permit App: 91002512 Reroof Sp kane County
Y
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue'Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: /1 J) OQ
O L1 ke/4/-4- 15-/PWAY
CITY/STATE/ZIP: Y - 4z L �4c/ 479-?3 ,r
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: �U G�,Lff PHONE: 7:2_, L ( 759'
MAILING ADDRESS: F-(1 -5'4D6( #2482-1-
CITY/STATE/ZIP: 19P-4-44,4-6_, 996'37
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: 1 LI C A k // - // / f 1,
1111 �j�
**************************************************************/, 4* *Al*•
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: X (WIDTH X DEPTH) SQ. FT. :
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: