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1992, 02-07 Permit App: 92000699 Reroof A of t Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: Me/dt PHONE: - 52„7 - k5 MAILING MAILING ADDRESS: / /2 / I CITY/STATE/ZIP: 49-/j',„E sh CONTACT: PHONE: - - SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: .. CONTRACTOR: A _ a _r1/2�i • ✓- *NE: ��D% - 9y - lac MAILING ADDRESS: /l/ //1 '2)/' 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 Electric baseboard or wall mount Propane Forced air gas Heat pump Other: Flat ceilings R Doors U Vaulted ceilings R Windows U Above grade walls R Glazing area °Yo: 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: