1992, 10-27 Permit App: 92009357 Reroof )0° Spokane County •
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: 2.495-7
STREET ADDRESS: Al i 67_1 U /}iId &•
CITY/STATE/ZIP: 5/916)0W, UU
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
,¢ OF BUILDINGS: I OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE: - -
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: -)o gu4, 16 NGI 64/ ONE: - 3 - d Tv 9
MAILING ADDRESS: (20 611)( 16 /"
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: I HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
a ,
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