1992, 11-23 Permit App: 92010338 RemodelSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: `7'%/ �' , SD. R VP r wQ(
CITY/STATE/ZIP: S pf) j.J67n 8_
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A:
WIDTH: DEPTH: R/W:
OF BUILDINGS: / # OF DWELLINGS:
OWNER: rA e /"i k i, Km o ule S
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: Ai' r ke
ke;e 1 w9gala
Cir r ti' )1,1 i �C
WATER DISTRICT: A/. /1 a0�'
PHONE: 7 - q3 - -10 ,P
1�i t o e S PHONE: $-t' — la — /e%/
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
16 ,,O6 0
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CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
BUILDING INFORMATION
ce `N/Ii
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE:
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 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:
/ C0
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LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE