1992, 06-26 Permit App: 92004754 RemodelSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: t^ J N 3 - O Z 02_ /27,4%
STREET ADDRESS: V 7 // .s�.�/
CITY/STATE/ZIP: 1/C, -ezc6_-Q, _/ I/AY"- YJc--•J i
SUBDIVISION: c C"inz7i i
BLOCK: / LOT: 2-) ZONE: /' a0 DISTRICT:
LOT AREA:
if OF BUILDINGS:
F/A: WIDTH: DEPTH: R/W:
# OF DWELLINGS: WATER DISTRICT:
OWNER: //' /l ,f c
MAILING ADDRESS: -2c)
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YU,9y
PHONE: - Cil g
CITY/STATE/ZIP: ,_'o,(/62_,MiCt 1J Z //
CONTACT: e, C cf.,--a7 Ill. PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: U"2S S 4'J "x44,
CONTRACTOR: ac w PHONE:
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION:4e CHANGE OF USE:
DWELL UNITS:
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 DOORS U
VAULTED CEILINGS R WINDOWS U
ABOVE GRADE WALLS R J? 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
CONTACT PHONE