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1992, 07-21 Permit App: 92005495 Reroof • 1144) Spokane County DEPARTMENT OF BUILDING & .SAFETY ( 3 / 9-1 West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: • STREET ADDRESS: 13 rd , CITY/STATE/ZIP: 1 , ` 019 A/ �O SUBDIVISION: • BLOCK: LOT: ZONE: DISTRICT: LOT AREA: 'F/A: WIDTH: DEPTH: R/W: • • # OF T'UILDINGS: # OF DWELLINGS: WATER DISTRICT: OWN ER: + +�� (' � PHONE: - Got - 7OS MAILING ADDRESS: CITY/f'TATE/ZIP: , &4 "l , CONTACT: Dan Chambers PHONE: ( 509) — 747 - 7335 SETBACKS: — FRONT: LEFT: RIGHT: REAR: PERMIT USE: Ro_rOdc �ul ��ru y� - ; Opp $Q 911 ***************************************************************'************* BUILDING INFORMATION CONTE :-.!TOR LICENSE NUMBER: EX'I ERD*160,J3 CONTE TOR: ] xter i nr 1)( itn ompany PHONE: (509) _ 747 _ 7335 MAILING ADDRESS: 1K 16 South N op I e Blvd . Spokane , WA 99;203 ARCHITECT/ENGINEER : PHONE: — — MAILI"G ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS : OCCUPANT LOAD: BUILDING HGT: . , STORIES: BUILDING DIMENSIONS : ;t (WIDTH X DEPTH) SQ. FT.': REQUIRED PARKING: 4 HANDICAP: SPRINKLERED: .. CRITICAL MATERIAL: .