1991, 09-25 Permit App: 91006218 MHSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
# OF DWELLINGS: WATER DISTRICT:
OWNER: /4 2)u j t? PHONE: soy -22"6 - //,3v
MAILING ADDRESS : E /700 /l`kadoc3droa , /1--)4
CITY/STATE/ZIP:
CONTACT t-----7/10
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PHONE : S c! — Z Z % — /13 b
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: fes'/ C S 7`.e,r) v 0 v -- /1/03/V. -a, �& /'4 /,/
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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: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
Please provide the following information for Energy Code compl?ance:
Space heating type (check one)
Forced air electric Electric baseboard or wall mount Propane
Forced air gas Heat pump Other:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area_ %:
Below grade walls R Total floor area
Floor R of heated space
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.
Square footage
Main floor:
Second floor:
Basement - Finished:
Unfinished:
Garage:
Carport:
Decks:
Additional Areas: