1992, 09-14 Permit App: 92007581 MH Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: ./ 'f.-'c 1 3.
STREET ADDRESS: a S 1 L 00 dA4ALLAJ
CITY/STATE/ZIP: 99Z b
SUBDIVISION:
BLOCK: / LOT: // ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: te^ I OF DWELLINGS: WATER DISTRICT:
OWNER: 2>€J K►.LOALkCYL PHONE: - -
MAILING ADDRESS: ,Le--t- -1?O,-&O!C () S Zq
CITY/STATE/ZIP:
• CONTACT: L (2PHONE: 9 - 3 et - 34335Z,
SETBACKS: — FRONT: Q LEFT: 3 RIGHT: ID, REAR:
PERMIT USE: `Y\ /€71)e 7 O -- ,R
******************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
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:
4 r
PLEASE PROVIDE THE FOLLOWING INFORMATION FOR ENERGY CODE COMPLIANCE:
SPACE HEATING TYPE (Check One)
FORCED AIR ELECTRIC ELECTRIC BASEBOARD OR WALL MOUNT
FORCED AIR GAS HEAT PUMP,
PROPANE OTHER:
FLAT CEILINGS R DOORS U
VAULTED CEILINGS R WINDOWS U
ABOVE GRADE WALLS R GLAZING AREA
BELOW GRADE WALLS R TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR R
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
-. _. .._. Initials Date
lA Otaw
_
/SIJ Approved by
_..- • S i 1 -.IV per.... Prepared by
1 2 3 -'>i do I- 4 J �� `5 6
I
--x.....-..>
- 1
r
1, I !
2 3a € i I' 2
{s
3 3
{
4 j 1 4
5 t
5
6 ppO l 6
V
,
7 7
8 4'"• Q/ 1 8
,
/ 9
0 I I
10 • i 10
11 y, 11
•12 c
HH•
3 16
i # 17
\ 18 i : 18
, _.. f ;......i. f • _.._.. , • •
19 , I 3 19X
j
I t
_
20 20
t
21 ; r •
• I 21
22t 22
?
23 �,0T� 1 ^ 45Qgi X35 • 23
24 1_ ( 4 �L j...
25 , I :
I` .
i )e..(7', ! • !, ,
l_
27 I • 7
2
28 # 28
29 _ 29
30 •
F , I 30
31 31
32
•
t
1 32
33 • f._. 1. , . i_ - H
I I 33
i ' 34
35 I 35
36 i ! •
{ i t
_� • 36
, I . I•
37 ; •
f� ; 37
38 I . f { _ 1 _. i 38
39 ;
{ { _ ; 39
. . , ,
40 1 . 40
iIt 1 II +
NO.7-45106 GREEN• QUILL CORPORATION-GENERAL OFFICES,LINCOLNSHIRE,IL 600699585 j