1990, 10-30 Permit App: 90005757 MH f Spokana:County OaD
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DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: Z so Oó
STREET ADDRESS: I j /) VE40 (
CITY/STATE/ZIP: S PO Ka Iv E ) WA . 9 c7.
SUBDIVISION: (O I\ (A)001\
BLOCK: o LOT: / 0 ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: 00 DEPTH: I 2,5 R/W:
# OF BUILDINGS: / # OF DWELLINGS: j WATER DISTRICT:
OWNER: VI , U f k ei IA) IA ct\ ) I PHONE: S O'- y - , 6.D (
MAILING ADDRESS: /Q `1 I S \)6LOX
CITY/STATE/ZIP: POK>4/u6 (A)4 .
CONTACT: PHONE: SD?- c.222_ 6 f
G--)V SETBACKS: - FRONT: LEFT: RIGHT: REAR:
*Vi)113t
PERMIT USE:
****************************************************************************
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:
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SPne County
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