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 %
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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: