1992, 03-19 Permit App: 92001684 Sewer S okane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMAT N WORKSHEET/
PARCEL NUMBER: / • iJ
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: (1/ARE h, 34-54DA) PHONE: 509 - 9024V - 9a0g
MAILING ADDRESS: E' 1/55 if
CITY/STATE/ZIP: VOA /9/1/...)2 LUX. T f
CONTACT: PHONE: -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: