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1991, 01-08 Permit App: 91000077 Chimney
Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA= 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS:_v�G/�c� CITY/STATE/ZIP: ( yr�,te.c lr/�.15 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: C� OWNER: ��y / ,, , PHONE: - - MAILING ADDRESS: v .�4e*EF CITY/STATE/ZIP: ,I,x.,G C CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: (/'1‘,e,?2 — 4( — .%'2) CONTRACTOR: ,/L" 7�.laS7"iLuc-7- PHONE: ,S-OF - 4', 7- .27// MAILING ADDRESS: Pe-e- ,ffi7.3e 17 "-7 ARCHITECT/ENGINEER: PHONE: - - MAILING ADDRESS: NEW: REMODEL: X 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: