1992, 02-27 Permit App: 92001128 Reroof,
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3 75
INFORMAA�TION WORKSHEE-T�
PARCEL NUMBER: / `� 11 �' //n J7�
6
STREET ADDRESS: � ��•J / 25 q /se-fd'3, e ?•
CITY/STATE/ZIP: Sv/, i(q -., e 4-&x • %I/
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OFF DWELLINGS: WATER DISTRICT:
OWNER: 7:744.-.7614714/X
i o I.-. / 61471 ' 4/X PHONE: - -
MAILING ADDRESS: S� .—/ c
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDINNG INFORMATION
CONTRACTOR LICENSE NUMBER:'w /r /2 19/7C -2/19/7C -2G C- /AP T D
CONTRACTOR: ,40 /r (� /fir°10 (oaf PHONE: ...6-9-,30,>(- O P4 j
MAILING ADDRESS: g Ste -25 -7 ‘y,z,_s� le.
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD:
BUILDING DIMENSIONS:
BUILDING HGT: STORIES:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING:_ # HANDICAP:_ SPRINKLERED:_ CRITICAL MATERIAL:
Please provide the following information for Energy Cede 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 U
Vaulted ceilings R Windows U
Above grade walls R Glazing area °/u:
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: