1994, 04-11 Permit App: 94002982 RemodelAPPLICATION WORKSHEET
General Information 6
q—alts?
Tb a rcss
5. 2.60 cN £S
Parcel number
Owner
DA_ L�iZ
-Mining address
-City
S.ZGo6 PSIS.
Phone
Lip
Site Information
Legal Description
as
I
Addition
Remodel
Change of use
Property sae
Water District
Numberol:
Dwellings
Buildings
Zone
Inspector .,'
Roadwidth
City. state, zip
Project Information
Permit Use Seo?
fin 61-1
as
New
Addition
Remodel
Change of use
1
Building Information
• 'e mg units
•ccupanl oa•
1m ang eig 1
tones
iw •ing rtmenstons
ota square ootage
•eq • par ng
'an'leap par ng
pnn Ver system
mica •atena
Square footage breakdown
Main Iloor
Uncovered /covered deck
Second floor
Other
banished basement
Ming address
kv /3ox (4/77/
Un(mished basement
Gauge
furnace Kency
Contractor Information
Heatin and insulation information R—value,
•eat source
atceung
•
.•ve gra ewa
ow gra ewa
Ming address
kv /3ox (4/77/
a, on gm•e
Mailing address
furnace Kency
ota wm•ow area
SSL/L{
73utlmg contractor
. /CAS; lit.sIM£R.
7" z-7 —ILLI41
Plumbing contractor
License number
Phone
Lice eAumbber_ =AsDI 1..fi3
Phone
Ming address
kv /3ox (4/77/
Mailing address
City, state, zip
Sno, Cir. .
SSL/L{
City. state, zip
Ileatingcontractor
Other/Lender
License number
Phone
License number
Phone
!r a t('1 ng address
-Nailing address
City. sla le. zip
City, state, zip
PROJECT CONTACT
PHONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675