1990, 09-19 Permit App: 90004737 Reroof Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 9a •
INFORMATION WORKSHEET c)
PARCEL NUMBER: r - O dq/
STREET ADDRESS: /3 (p w e.I ) S k y
CITY/STATE/ZIP: p A iq N
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNE �- r �� PHONE: - -
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: - �T f ( OC)
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: /-1; C k. e h. (a D
3-07
CONTRACTOR: /h4 ,c k 14leD 0-7', N 5 PHONE: -127 - 64rgip
MAILING ADDRESS: ciU PC M) /2 ,5/4 p ok/91ut
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: 4( HANDICAP: SPRINKLERED: CRITICAL MATERIAL: