1992, 05-29 Permit App: 92003827 Remodel Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: S• U05Up05 NkCck Oreg ('
CITY/STATE/ZIP: / eC l.e �✓� �����
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: \c\ja c¢v�S�b- PHONE: -7ocf - 0700
MAILING ADDRESS: c_s
CITY/STATE/ZIP:
CONTACT: 1:c,aY0 \ \tk.v� 5 �• PHONE: - - Ci3
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: !0liezia4ca_tb:74
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: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
Please provide the following information for Energy Code compliance:
•
Space heating type(check one)
Forced alr 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 oh:
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:
•
Decks:
Additional Areas:
•
•
•
•
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: