1992, 07-30 Permit App: 92005919 ReroofSpokane County
DEPARTMENT OF BUILDING &SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS:
CITY/STATE/ZIP: S Ona f'/ 41(1
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
# OF DWELLINGS: WATER DISTRICT:
OWNER: e)lop,r,/-a..
4/e Je he. r
MAILING ADDRESS: MAva
CITY/STATE/ZIP:
PHONE :.nd 1 - ,e -
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: Ji1 4 Q
CONTRACTOR IJ 1/1)1C( (PHONE : 569 -
5
MAILING ADDRESS: / V r 1E(' VJJIJI c +
009
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:
Please provide the following information for Energy Code compliance:
Space heating type (check one)
Forced air electric Electric baseboard or wall mount Propane
Forced air gas Heat pump Other:
Flat ceilings R Doors
Vaulted ceilings R Windows U
Above grade walls R Glazing area
Below grade walls R Total floor area
Floor R of heated space
Slab on grade R Furnace efficiency rating
Please Indicate on your plans: The location of the radon vent, and the location of the vent fan area.
Square footage
Main floor:
Second floor:
Basement — Finished:
Unfinished:
Garage:
Carport:
Decks:
Additional Areas:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT:
PHONE: