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1995, 06-06 Permit App: 95003884 Reroof • qb 3 '1,VqSpokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: ( // ' 7 STREET ADDRESS: ())0 ' ��'� 1 CITY/STATE/ZIP: 0 SUBDIVISION: BLOCK: LOT: ZONE: - DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: PHONE: - - MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: rot: k- �' c rfya **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER l4-CIC CONTRACTOR: !' $ i4./' 1 (0 ----ACr tr i PHONE:: MAILING ADDRESS:;,,,_. _ ARCHITECT/ENGINEER: PHONE: - - i 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: i