1991, 12-12 Permit App: 91008581 PoolSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARC:. NUMBER:
TRE
CITY/STATE/ZIP: �O�C/'� i✓� (��i�
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF P7ILDINGS:
OF DWELLINGS: r?ATER DISTRICT:
OWNER: /6269/6 A/- _.HONE: - -
MAILING ADDRESS: `c- 7
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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CONTRACTOR LICENSE NUMBER:
BUILDING INFORMATION
caST10/1)090-xZ
CONTRACTOR: 2;) // //A.5 -ME PHONE: R7,0_
MAILING ADDRESS : / xee55 C '/97 ...$)-/,51.41,-04‘.._ (Li
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:
'lease 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
ceilings R Doors
ceilings E= LVinduws
A`oa walls Gla. ni� ,3r, ..
fkoor ;:• ..
Floor R of heated space_
Slab on grade R Furnace efficiency rating
Propane
Other:
'lease indicate on your plans: The location of the radon vent, and the location of the vent fan area.
Square footage
Aain floor:
>econd floor:
3asement - Finished:
Unfinished:
>arage:
:arport:
/ecks:
,dditional Areas:
C.."(J
To\
6
CO -
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