1992, 01-10 Permit App: 92000186 Seweraz -(5a
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: S / 727 / /-t' 5 Ao/ ,
CITY/STATE/ZIP: Spc4(1,t/5- 41444/71 9-720 4,
SUBDIVISION:
BLOCK:
LOT AREA:
# OF BUILDINGS:
LOT: ZONE: DISTRICT:
F/A: WIDTH:
# OF DWELLINGS:
OWNER: 7)4(///) ,(0 ,()/�N/�L
MAILING ADDRESS: /3,r 904 -
DEPTH: R/W:
WATER DISTRICT:
PHONE:
CITY/STATE/ZIP: g41434/244-4.4
4//4-7963,
CONTACT: PHONE:
SETBACKS: - FRONT: - LEFT: RIGHT: REAR:
PERMIT USE:
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
BUILDING INFORMATION
PHONE:
MAILING ADDRESS:
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 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 a/o:
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: