1995, 03-13 Permit App: 95001333 Reroof5 _ 1335
APPLICATION WORKSHEET
General Information
Owner
Phone
Mailing address
(ono . nifs inF&.
City s✓1h K al.st.
L. Site Information
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Sta le
IA) A7
Lap
Legal Uescnptwn
Property size
Water Uulnct
2 2I?Asks
n:.
Number oL•
>titodawaq!!a
Dwellings Buildings
Project Information
LPermtl Use N S`D.17 3, o f
14ddtlwa
remodel I linage of use
Building Information
Dwelling units
Occupant load
Mudding height
Stores I
titidding dimensions
1._
I otal square lootage 1lteq'dpadang
Handepparkang
Sprinkler system ICnlitalMatcrul
Square footage breakdown
Main floor
Uncovered /covered deck
second Moor
Other
-brushed basement
Hoer
Untinuhed basement
Door (u -value)
Oange
Furnace etlicency
Contractor Information
Heating and insulation information (R -valuta) P
Heat solute
Halceding
Vaulted ceding
Above grade wall
Meow gradewall
Hoer
Slab on grade
Door (u -value)
Window
Furnace etlicency
Iota! window area
Y.ol Moor area
Uualdm contractor
Face eicon I'ls'i' '
Plumbing contractor
Lice e�nnumber n �-r Phone t�-
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License number
Phone
Mat �inad ft":{ .-S0 F*y1
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UM if 171 j55/Or\
Mailing address
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Lily s(taI4 Zip
elK WA 9'9a is
Lily. Stilt. lip
Heal itlg contractor
Other / Leader
License number Phone
License number
Phone
Mailing address
Mailing address
City, sue, zap
Gly. 31114 up
PItOJecr CONTACT
PHONE
Spokane County Division of Buildings