1992, 06-19 Permit App: 92004546 Re-Roof • . Spokane County
DEPARTMENT 0P BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99266 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: C `�
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION: 76Yic49eer/
BLOCK: -/ LOT: / ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: L42_1 / _,t j PHONE: - q1rc(" 49,5 7y
MAILING ADDRESS:
. CITY/STATE/ZIP:
CONTACT: PHONE: -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 6
CONTRACTOR: ( -6 � � = PHONE: - %'G/L/ -
MAILING ADDRESS: / ') (., 7 C > /
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:
ease provide the following information for Energy Code compliance: •
-
dace 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 010:
Below grade walls R Total floor area
Floor R of heated space
Slab on grade R Furnace efficiency rating_
lease indicate on your plans:The location of the radon vent,and the location of the vent fan area.
Square footage
lain floor:
econd floor:
easement—Finished:
Unfinished:
garage:
:arport:
•
)ecks:
ldditional Areas:
•
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: