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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 Ge P.1) .4cPs Jus -0 zei-9 .rte g9O 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 /,/ sa �4*rel" / r,17A/ J �V.Jm,, Q. S >L c/.o . 2 ************************************************************************** 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: