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1995, 03-21 Permit App: 95001600 MH/06 APPLICATION WORKSHEET General Information Owner Qa(A e--er5 Mailing address city 1((ct o E M eud owl �t�ooI 2 5 W G! ()veevtQCt,'' Picone a27- 11`(01 Gip ggoI6 Site Information Legal Description Property size Water Distnct Number ot: -Dwellings Buildings t Project Information Penmt UseNew h'��.���-- how Main floor Addition Remodel Change of use Building Information Dwelling unitsi Main floor Uncovered / covered deck Occupant load Other Building height Stories / Building dimensions L) , / VL T otal square [Dotage 16,o 6 O D Total window area 7 Zteq'd parking Handicap parking Sprinkler system Cntical Matenat Square footage breakdown Main floor Uncovered / covered deck Second floor Other Finished basement Floor Unfinished basement , Garage 1 Furnace etticency Contractor Information Heating and insulation information (R -values) ` Heat source l Hat ceiling Vaulted ceiling Above grade waU Below grade wall Floor Slab on grade Door (u -value) Window Furnace etticency Total window area 7 '90 of Floor area 1 ltui(diag confraeto V -144 -1I -COL -M e-5 Phone Plumbing contractor License number Phone License number Maduig address_ 1- L J� e -C -3r ra u e Mailing address t:ity, s zi Lk Q r I City, state, zip Heating • ntractor Other/ Leader License number Phone License number Phone Mailing address Mailing address City, state, zip City, state, zip PROJECT CONTACT PHONE Spokane County Division of Buildings 1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675