1992, 11-12 Permit App: 92010013 Fire Damage RepairSpokane County
DEPARTMENT OF B UILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: E /5-010 S U p 1 U ,mac,
CITY/STATE/ZIP: S Po l 9? -1 c
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: W; i /l'etw• 4— Cjk (15+1 vac.. Q vGk ko (4t PHONE:
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT:
Gtir,k.11.)14 t
SETBACKS: — FRONT:
PERMIT USE: r e_ PQ ;
PHONE:
- 3?1 -/6ss u k,
LEFT: --RIGHT:
,7:R:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: C e /u S TA- 5 095 P
CONTRACTOR: �S �cvGVI / - SOC. o T Spv . me . PHONE: 50 9 —6,1Y-9/
[ S.
MAILING ADDRESS: P o. 86,c
ARCHITECT/ENGINEER:
MAILING ADDRESS:
/8 /01 562e) 9
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:
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LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE