1991, 09-17 Permit App: 91005913 Sewer Spokane County
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DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: SL ` I '-(j
STREET ADDRESS: x" 24(-! 5 /5-122
CITY/STATE/ZIP: --S,1L24- ec.,e i�/ %y���
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SUBDIVISION: / )p ._.iC. L ESI
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BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
41 OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER:4::/1744:%c.i 4 4-1/ PHONE: .SG —
MAILING ADDRESS: �S jG � /�=,C J, '�1 /y
CITY/STATE/ZIP: j',9
CONTACT: J / t % G l G% ��—��%7� PHONE: j 5 —
SETBACKS: — FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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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:
Please provide the following information for Energy Code complianc&
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 %:
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: