1992, 06-05 Permit App: 92004056 ReroofSpokane County
DEPARTMENT OF BUILDING &SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
2€6d'I- /102.
STREET ADDRESS: S, 3 7/6 /R. ' ES'
CITY/STATE/ZIP: ,5' kite / Lc) 79 SN
SUBDIVISION:
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BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUI,DINGS: # OF DWELLINGS: / WATER DISTRICT: [- 3
OWNER: a) AL I A-/4 L.c..-7/3R/1/ y6=+6 PHON-431S
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MAILING ADDRESS: S. 7/ 6 '//t 2 A
CITY/STATE/ZIP: S /a O /C,&4, C A) MSN--- S 9 a r0 G
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE:
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL:. ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: c BUILDING HGT: STORIES:
6
BUILDING DIMENSIONS: / x as' (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
Electric baseboard or wall mount
Heat pump
Propane
Other:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area `E0*
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:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT:
PHONE: