1994, 09-29 Permit App: 94009563 Reroof 1(7, 5'("5
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
, � INFORMATION WORKSHEET
PARCEL NUMBER:
` '021 " 2-7[2
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION: T 1•�.ht [-3f7 O r c;\, S AAA e rS Li Z 3 1
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: • F/A: WIDTH: DEPTH: R/W:
I OF BUILDINGS: I OF DWELLINGS: WATER DISTRICT:
OWNER: jig C r . PHONE: - —
MAILING ADDRESS: E. /41 '
CITY/STATE/zIP: rre : o c La 9 9 21 G
CONTACT: ( ,e; l 17t 0Li PHONE: c R - 92,L C z ' _1
SETBACKS: - FRONT: LEFT: RIGHT: REAR: •
PERMIT USE: p r pc, 'r Z- y ,
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BUILDING INFORMATION
CONTRACTOR LICENSE. NUMBER:. Lair 5 E N 173
K c
CONTRACTOR: (-f) ti's Q ,e,r S PHONE: 5 0
MAILING ADDRESS: 5 . . L./2_ 19g 1 v 1 A l- 5 t-,r c&ti Lc i 4 qgZ o
ARCHITECT/ENGINEER: ._.. PHONE: - MP.
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: CRTTTrAT• MATRPTAT..
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.
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SQUARE FOOTAGE:
MAIN FLOOR
SECOND FLOOR
BASEMENT - FINISHED
UNFINISHED
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
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LENDER/BOND HOLDER:.
ADDRESS