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1992, 10-21 Permit App: 92009195 Siding, RemodelSpokane County DEPARTMENT OF BUILDINGS West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATIION WORKSHEET (kms 72_:(-J PARCEL NUMBER: STREET ADDRESS: CITY/STATE/ZIP: 9220 cf 1/4S/et>7-0 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: # OF BUILDINGS: rZ if OF DWELLINGS: WATER DISTRICT: OWNER: L f U ti,f-(R o !-1 ( G-6- PHONE: - 2`7/7(- 6/6 MAILING ADDRESS: %3 © k �? 6 CITY/STATE/ZIP: 0/ l ?7(«G* I '.�i ��? , ?P0 CONTACT: PHONE: SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: ****************************************************************************** CONTRACTOR LICENSE NUMBER: BUILDING INFORMATION CONTRACTOR: --/-;41/U(c//5 MAILING ADDRESS: PHONE: ARCHITECT/ENGINEER: MAILING ADDRESS: NEW: REMODEL: DWELL UNITS: PHONE: ADDITION: CHANGE OF USE: OCCUPANT LOAD: BUILDING DIMENSIONS: X BUILDING HGT: STORIES: (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 FORCED AIR GAS HEAT PUMP PROPANE OTHER: FLAT CEILINGS R t/ 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. ******************************************************************************* SQUARE FOOTAGE: MAIN FLOOR SECOND FLOOR BASEMENT - FINISHED UNFINISHED GARAGE CARPORT DECKS ADDITIONAL AREAS: ****************************************************************************** LENDER/BOND HOLDER: ADDRESS CONTACT PHONE