1991, 11-26 Permit App: 91008239 MH M
SpoCane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL/NUMBER: . .
STREET ADDRESS: /
, 12<sia yn_ [ 1 e C-j,LA )04A_AL), d J--..
CITY/STATE/ZIP: (J--0. ' & IA ( 9g0/6
SUBDIVISION: / "?_ 1 U J
t'O--e-i . • . . •
BLOC : - •T: 'NE: STRICT: •
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LOT AREA: F/ • . WIDTH: •EPTH: R/W:L.
# OF BIIILDING=: # OF DWELLINGS: WATER DIS ' c CT:L
OWNER: rmJm tnil'1P_ Ot �)l/M t et,l,c)C'(L PHONE: •422- 2,j)
.. MAILING ADDRESS: , / ?</ •LJ(k //e C
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• CITY/STATE/ZIP: ' 3-11,(0.ei)Ott2.4°S � � �. .
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CONTACT: II4 I/ •IA I, 1.jeSPHONE: .9 - i�
SETBAOK$: - FRONT: . LEFT: RIGHT: REAR:;- .
• PERMIT -USE: . . .
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•• BIIILDING INFORMATION . ' '• - - . •
. CONTRACTOR LICENSE NUMBER: . .
• CONTRACTOR:' PHONE:•• - -
• • . MAILING ADDRESS:
. . •ARCHITECT/ENGINEER: • •- PHONE: • - • '
.. MAILING•ADDRESS: . • . . • . . . • • . .. . .
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BIIILDING HGT: STORIES:
BIIILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. :
REQUIRED PARKING: #. HANDICAP:_ SPRINKLERED: CRITICAL MATERIAL: .
Please provide the following information for Energy Code co p'lanc
. e:
Space heating type(check one)
Forced air electric Electric baseboard or wall mount Propane
Forced air gas Heat pump Other:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area 0/0:
Below grade walls R Total floor area
Floor R of heated space
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.
Square footage
Main floor: • • .. .
Second floor:
Basement- Finished:
Unfinished:
Garage:
• .Carport:. . S S
• Decks: : .. . . . . . . .
.' •Additional.Areas: '•. •