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1993, 04-21 Permit App: 93002758 Repair Fire DamageIPROICCI CONTACT APPLICATION WORKSHEET ll General Information Job ddress ,,,A / 5 /1,/a/0/✓/iie Owner e4,0 ce.41-Cg. Mailing address / y .2 / /f/ snA*nCZ Lay S.eogrfic Site Information Legal Uescnpllon Property sae Project Information Water Untnct Inspector V I P r ll `7 1 S 1 r 070 1 Permit uR pA f ISlta et nEJ Building Information State Number of RbadWIdlh Addition Picone 6dp Dwellings Buddmgs 1 Remodel I Changeclose t, Dwelling units Building dimensions Occupant load 10121 square toouge IBudding height Req'd parking are footage breakdown am Boor Second Boor Finished basement Unhnished basement t,arage Uncovered /covered deck Usher [ Contractor Information uwld - cpotgctor o 4 nom r JtTD Cost License Mailsng address /eo 5J 6In. Lity, slate, zip 1n \ �? Di 7 ColtiedvF�P. G' JD i Phone /16023y/V/P Heating contractor License number Mailing address City, slate, ap one Stones 1 IHandicapparting Sprinkler system jlantral Materw Heating and insulation information (R—values) Heat source Flat ceding Below grade wall Door (u—value) total window area Vaulted ceding Floor Window 1 Above gradewall blab on grade Furnace elliceocy % of Iloor area i Plumbing contractor License number ailing address Phone Lily, slate. rap Other) Lender License num Mailing address Clly, slate zip Phone PHONE Spokane County Division of Buildings 1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675