1992, 11-18 Permit App: 92010131 Reside Gables, Dormer Dca- \ Ori \
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
• STREET ADDRESS: 4.34 .17/ A �j�/
CITY/STATE/ZIP: L 2/QtL Ai/j.
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: /(1 61'b I 1'A/i✓ / ;% / 2 PHONE: - -
MAILING ADDRESS: /$ / /rei �/s�
CITY/STATE/ZIP: /cArtA/„,r.. AA)„
CONTACT: PHONE: - -
SETBACKS: - FRONT: LEFT: -RIGHT: REAR:
PERMIT USE: /0.73>/.6Z- ei Ute/ // A-t
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BUILDING� INNFORMATION
CONTRACTOR LICENSE NUMBER: �'IL
� __" � C /02/ _//
CONTRACTOR: /I/14 4 /x PHONE: 6277 -
MAILING ADDRESS: j/ S � _Sf A)ed-ec44
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:
i
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