1990, 08-28 Permit App: 90004260 Sewer Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: b&A,ItcL U c O f'_,. ( PHONE: - -
MAILING ADDRESS: t� '�� ��„ }
E i !
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 1111\ ‘,4 S I 2., r 1 k
CONTRACTOR: u el C P+r' tti ).;,tr F r`,t ill"' PHONE: 5:1-1L1 .7 ii(3 -
MAILING ADDRESS: t:' , ? ( ,
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: