1993, 10-12 Permit App 93009645 MH`Y� GVJ�C/3 iv
APPLICATION WORKSHEET
General Information
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Site Information
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Project Information
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Dwelling units
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Building height
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Building imensions
Total square footage
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Finished asement
City, state, zip
Unfinished basement
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Contractor Information
Bttsaned insulation information (R—values)
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Flat ceiling
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window area
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License number one
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Mailing address
City, state, zip
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Beating contractor
Other / Lender
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Mailingaddress
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City, state, zip _ —
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PROJECT' CONTACT PIIONI:
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675