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1991, 05-02 Permit App: 91002269 Reroof Sji ..bane-County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: // / / 4, - f CITY/STATE/ZIP: � 7 /1/ /444- SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS:: �i"� # OF DWELLINGS: WATER DISTRICT: OWNER: l/(1�// "e - PHONE: ASO q - /Z Z 1-- MAILING ADDRESS: , G ')6 7 7 CITY/STATE/ZIP: � r L C� rT 6 3 CONTACT: ,o/ // PHONE: 5 72�-� z J 7 _- /7-SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER:J CONTRACTOR: � G- f PHONE: 5-61 -�2 z - /'7 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: