1993, 01-27 Permit App: 93000393 BasementSpokane County
u� D PARTMENT OF BUILDINGS
st 1303 Broadway Avenue Spokane, WA 99260
PARCEL NUMBER:
INFORMATION WORKSHEET
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STREET ADDRESS: 1,!V,12 2-
CITY/STATE/ZIP:
CITY/STATE/ZIP: 'c. A'' L( "-
SUBDIVISION:
(509) 456 365
BLOCK:_ LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:/ # OF DWELLINGS: ( WATER DISTRICT: )9,-,,i `i
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OWNER: �I.r r, �,..�
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PHONE:�-
MAILING ADDRESS:
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CITY/STATE/ZIP:
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CONTACT: L,
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PHONE:
SETBACKS: - FRONT:
PERMIT USE:
LEFT: RIGHT: REAR: '
BUILDING INFORMATION /� %��j n
CONTRACTOR LICENSE NUMBER: L 4,v r U
CONTRACTOR: r' C c, PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: QU rj 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: I HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
PLEASE PROVIDE THE FOLLOWING INFORMATION FOR ENERGY CODE COMPLIANCE:
SPACE HEATING TYPE (Check One)
FORCED AIR ELECTRIC ELECTRIC BASEBOARD OR WALL MOUNT
FORCED AIR GAS HEAT PUMP
PROPANE OTHER:
FLAT CEILINGS R
VAULTED CEILINGS R
ABOVE GRADE WALLS R
BELOW GRADE WALLS R
FLOOR R
SLAB ON GRADE R
DOORS U
WINDOWS U
GLAZING AREA $
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
JOB STREET ADDRESS:
CITY/STATE/ZIP:
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (ZIP)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (ZIP)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
=AMOUNT
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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4) Finish sill height
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44 inches above floor (ma4
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