1992, 05-04 Permit App: 92003053 ReroofSpokaneCounty
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: N 4/3 k/1 Le -ow gp
CITY/STATE/ZIP: S PKR-sJE IA -1 I'l 9,020
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: /sIOOE2a
OWNER: Pstbv/s -)�"ZtiL3vitt soPHONE: 09 - 9..28" - 24493
MAILING ADDRESS: S977:46
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: J^�
PERMIT USE: 7� . "vcT ( C� 6 36 -
LEFT:
RIGHT:
REAR:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
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:
?- 4
Please provide the following information for Energy Code compliance:
Space heating type (check one)
Forced air electric Electric baseboard or wail mount Propane
Forced air gas Heat pump Other: WQoy'
Flat ceilings R Doors ; U
Vaulted ceilings R Windows U
Above grade walls R Glazin_ g area We
Below grade walls R Tottal floor area •
Floor Rof 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:
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