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1991, 06-25 Permit App 91003633 Re-RoofSpokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: Q Sf ©4, A . _ CITY/STATE/ZIP: �� / / (AJq, (Jl!" SUBDIVISION: BLOCK: ___4" LOT: /‘ ZONE: DISTRICT: LOT AREA: F/A: a3G7 WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: MAILING ADDRESS: e . ?'U? _ (? t1 CITY/STATE/ZIP: CVO, CONTACT: PHONE: 2 / -1_42D e_ *7 PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: 1.436 U 2 c- /(Dc / CONTRACTOR: d7)(,( E/k) S /2--C9:9 C /ni /'_ PHONE: 52 MAILING ADDRESS: S. 3 3/2T- ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: }{ (WIDTii X DEPTH) SQ. FT. REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: