1992, 10-22 Permit App: 92009236 MH Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: f, '7ao E. Va,j/e €_.(A) Cf.)(.c.fi f Mt CP Vev)
Mme per
CITY/STATE/ZIP: r .e na C -e.,s r �a-- 99 0 1 la &u-Lek, ,ct
SUBDIVISION:
BLOCK: LOT: 3-- ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
1 OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: 10)171 CUi d ,b O n ViGI P QiYYI CL1 i PHONE: .5-67 - -% (a - 36)-d )
MAILING ADDRESS: I? 7,2o E e--to
CITY/STATE/ZIP: l�e e (cc reS Ufa. 9 Q v/�
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: /4 X '70 Flee,&woad 1981
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
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: 1 HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
r^
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