1994, 05-25 Permit App: 94004720 Reroof qq7•
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Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
1
STREET ADDRESS: E. I i`i O C) L ,) Gk I S t u s 0 rr��
CITY/STATE/ZIP: sS/n � � { Lci A, 9 ci
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: • F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
4
OWNER: 4, �_ PHONE: - -
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: a ,/ - • PHONE: - ?24. - o Z g 1
SETBACKS: - FRONT: LEFT: RIGHT: REAR: •
PERMIT USE: P ,h 06 ) e3 on
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: /4 ) T s //\/ /V Z 1 . 3 k'1.c )
CONTRACTOR: LA3 f 5 . 1\1 f Q .Q N5 PHONE: - ` Z c)7_ 11
MAILING ADDRESS: .. z6
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
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 II.
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
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Spokane, WA 99206 .°� d Tr,, '3',„ ,x ,-�h
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I—.DETACH TO DISPLAY CERTIFICATE_