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1991, 12-23 Permit App: 91008765 MHSpokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET STREET ADDRESS: / 7 c)-) 2 CITY/STATE/ZIP: ��a WO 770l6' SUBDIVISION: BLOCK: LOT: , ZONE: DISTRICT: LOT AREA: F/A: WIDTH: �� DEPTH: t/ S- R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: _ � � PHONE: ($"U - 2322_ - 1-"40 MAILING ADDRESS: pc, CITY/STATE/ZIP:-y CjzJ2 / �J y`?U / (o CONTACT: PHONE: 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: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: 'lease provide the following information for Energy Code compliance: ;pace heating type (check one) Forced air electric Electric baseboard or wall mount Forced air gas Heat pump Flat ceilings R Doors 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 Propane Other: ,lease indicate on your plans: The location of the radon vent, and the location of the vent fan area. Square footage /lain floor: second floor: 3asement - Finished: Unfinished: garage: ;arport: )ecks: .dditional Areas: