1995, 05-24 Permit App: 95003574 Reroof Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: S S . 31 o -4- 3 / p i P tv o Vs
CITY/STATE/ZIP: 0. LA A ?Z. 0 (o
SUBDIVISION: tt
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
I OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: 'Po v1 � QtGVt r PHONE: 5-2=1 - `TZ41 - Cfl ! $
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: s. 1;v1 e tiQ v S PHONE: S'D? -q z - 02- q7
SETBACKS: - FRONT: . LEFT: RIGHT: REAR: •
PERMIT USE: -rea v 0 K 2 if` c ,,5-e-700, Oda
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BUILDING INFORMATION
CONTRACTOR LICENSE._NUMBER: 5_E.N A4 Z 17-3 f-
CONTRACTOR.: /Ist _ r'1_e e.r 5. .T c PHONE: So? -- 2 - a.7- 1 7.
MAILING ADDRESS: 2-11. _ . �c� r ;, ! cl 7-0 ,:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
f.
BUILDING DIMENS]ONS: X (WIDTH X DEPTH) SQ. FT. :
REOUIRED PARKING: # HANDICAP: SPRINKLERED: C_RTQPTrAT. MATPRTAT.•
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