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1991, 11-12 Permit App: 91007766 Roof Repair$pokoiio=County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 PARCEL NUMBER: INFORMATION WORKSHEET1 J ' J ) (ens % Th STREET ADDRESS: ,5. 1711 P, at' Rode/ ,,gM CITY/STATE/ZIP: 5Ookgn2 1 Jset+. ny11on ,9 if SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: OWNER :yAn MAILING !DDRESS: S # OF DWELLINGS: WATER DISTRICT: DyfoV) l) (( f, tat 'dcrif PHONE: CITY/STATE/ZIP: 3/oke,rtt, 1w/4dsinf/'+n ciga16 CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: KtenOe L= (013s CONTRACTOR: (C ri ( C em5-1 ik S1 n ✓1 MAILING ADDRESS: jij S t) d f/ �jctr f PHONE: Soy - YtS3 - 'q30D 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 %: 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: