1993, 07-28 Permit App: 93006339 SidingL Building Information
1-41511,J, /30
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APPLICATION WORKSHEET
General Information
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Job address
.21 /D o la /v7.vv�.vC';., ,.� , •y . 1 og' G v
I'areel number
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Owner
Mailings dress
Phone
9a 7- VVI/
City
State
Lip
Site Information
Legal Descnptioa
Property sae
Water Dislnct
Numberol: DweUmgs
lsuiWmgs
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L Project Information y
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Dwelling units
Occupant toad
Building height
Stores
Cbangeol use
Budding dimensions
Pernit Use
Req'dparksng
r
New
tAdditan
Remodel
Y6 of door area
1
`
I eating contractor
Dwelling units
Occupant toad
Building height
Stores
Material
Budding dimensions
Total square footage
Req'dparksng
Handicapparivng
Sprinkler system
Critical
1
Y6 of door area
City, state, zip
Square footage breakdown
Main floor
Uncovered !covered deck
Second floor
Other
finished basement
Hoor
-Unfinished basement
Door (u—value)
Garage
1
Furnace cltaency
Contractor Information
Heating and insulation information (R—values) 1
Heat source
Nat
Vaulted ceiling
Above grade wall
Below grade wall
Hoor
Slab on grade
Door (u—value)
Window
Furnace cltaency
Total window area
ti
Y6 of door area
Building cTnt,r.actor
(.°At 1P 73S /9b5�
Plumbing contractor
1
License n ger
S w >; C l <� 7 �/� -r
Phone
License number
Phone
Maim a dress
yo A)• RR -1s Aivu7h,
MaTngaddress
City. stat`pi
�6 t "l�t ) I t -P' 9 7 2 6
City, state, zip
Other /Leader
I eating contractor
-License number
Phone
-License number
Phone
-Nailing address
TN ding address
City. state. zip
-City. state, zip
PROJECT CONTACT
PHONE
Spokane County Division of Buildings
• REGISTERED AS PROVIDED BY LAW AS A:
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PORTLAND OR 07203
SIGNATURE
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ISSUED BY2ERTMENT OF LABOR AND INDUSTRIES
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