1992, 04-24 Permit App: 92002836 ReroofSpokane County' -
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS:
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CITY/STATE/ZIP: r5�`�/� iAJ 0.)// / ///� 1
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: // ,,%/ ;t/ 1//t9.4
'//PJ PHONE:
MAILING ADDRESS: /97V4 r
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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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 compliance: -
Space heating type (check one)
Forced air electric
Forced air gas
Flat ceilings R
Vaulted ceilings R
Above grade walls R
Below grade walls R
Floor R
Slab on grade R
Electric baseboard or wall mount Propane
Heat pump Other:
Doors U
Windows U
Glazing area 0/0:
Total floor area
of heated space
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:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT:
PHONE: