1992, 10-30 Permit App: 92009552 RemodelSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
Jr INFORMATION WORKSHEET
PARCEL NUMBER: L 5 03 2 r'/ O S
STREET ADDRESS: 'V N i U i I� e o A c [)
CITY/STATE/ZIP: -5F'ok r+N�. to
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: 3.31 AceE»/A: WIDTH: 3q V ' DEPTH:3 6 9 , R/W:
# OF BUILDINGS: 1 OF DWELLINGS: / WATER DISTRICT: /(<orui.ioo p
OWNER: Micir'e. 4 LIY>✓}114R2 S PHONE: 5d `1 _ 134/— X77
MAILING ADDRESS: E 12_9 le
Z2„7
CITY/STATE/ZIP: 5 r u it q w e w ✓{— / g z L
CONTACT: M,
PHONE:
QS et
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
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: f 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
FORCED AIR GAS HEAT PUMP
PROPANE OTHER:
FLAT CEILINGS R ' DOORS U
VAULTED CEILINGS R WINDOWS U
ABOVE GRADE WALLS R GLAZING AREA %
BELOW GRADE WALLS . R TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR R
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.
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SQUARE FOOTAGE:
MAIN FLOOR 0614
SECOND FLOOR LI 4 7 -
BASEMENT
BASEMENT - FINISHED
UNFINISHED 8 $
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
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LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE