1993, 09-27 Permit App: 93008915 ReroofGeneral Information
APPLICATION WORRSHEET
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IParcel number`-' V , I 1
Site Information
State
zip/ 7 �D 7
Legal Description
Occupant load
Budding height
Stones
Building dimensions
IolaI square loolage
Property sae
Water Utstnct
Number ot:
Dwellings
Buildings
Zone
Inspector
Road width
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Project Information
Permit Use
Building Information
New
Addition I Remodel
change of use
1
Dwelling units
Occupant load
Budding height
Stones
Building dimensions
IolaI square loolage
Req'd parking
Handicap parking
Spnnkler system
Cntical Material
Furnace etlicency
local window area
Sparc footage breakdown
Main floor
Uncovered /covered deck
Second floor
Other
Finished basement
Floor
Unfinished basement
Door (u—value)
Ga mge
Furnace etlicency
Contractor Information
Healing and insulation information (R—values) t
Heat source
Hat ceding
Vaulted ceiling
Above grade wall
Below grade wall
Floor
Slab on grade
Door (u—value)
Window
Furnace etlicency
local window area
hof floor area
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Plumbing contractor
,tis
liel'unwer "'AA�
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License number
Phone
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City. state. zip
Heating contractor
Other/ Lender
License number
Phone
License number
Phone
Ma ding address
Ma ding address
City. stale, zip
City, state, zip
PROJECT' CONTACT'
PIIONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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SIGNATURE
IS BY DEPARTMENT OF LABOR AND INDUSTRIES
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