1995, 08-25 Permit App: 93007525 Reroofc—-�5 5
APPLICATION WORKSHEET
General Information
Job address,,j ''�
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1
iia rawer
Owner
1. almg •ress, 4
6
city
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Phone
Lip
Site Information
Legal Uescnpuon
Properlysize
Water District
umber0
ellmgs Buildings
Lone
Inspector
Road width.
Project Information ,,,
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Building Information
New I Addition
Remodel
X
IChange of use
r
v
Dwelling units
Occupant load
Building height
Stones
Budding dimensions
total square lootage
74 -7---302
Regd parking
Handicap parking
Sprinkler system
Lntral Ma tercel
Furnace elltcency
Iola) window area
SSq�uare rootage breakdown
Main Moor
Uncovered /covered deck
Second Boor
Other
Finished basement
Floor
Unfinished basement
Door (u—value)
Gange
Furnace elltcency
Contractor Information
Heating and insulation information (R—values) t
Heat source
Hal ceding
Vaulted ceiling
Above grade wall
Below grade wall
Floor
Slab on grade
Door (u—value)
Window
Furnace elltcency
Iola) window area
% o1 Moor area
Budding contractor
Plumbing contractor
License number
Phone
License number
Phone
Mailing address
Mailing address
City, state. zip
Lily, sate, zip
Healing contractor
Other/Lender
License number
Phone
License number
Phone
Mailing address
Mailing address
City, stale, zip
City, sale, zip
PROJECT CONTACT
PIIONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675