1992, 07-14 Permit App: 92005243 Window Spokane County
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DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: . (1 j Z'-( W 11.-01A,i2 {ZQ
CITY/STATE/ZIP: spoi<AI'J i)A
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: rtGN- 4 t.-1.10 OA- 3-4.7642-614A PHONE: ,SO? - S,3 7
MAILING ADDRESS: S. Ill 2 t• 1C-15(4 Rt0 .
CITY/STATE/ZIP: 5fOiKAVs tAJ/A-
CONTACT: 1E5(2aC }(-to,) PAT-M LCAAM PHONE: q -32 c - :sS'3 Y
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: )000.714-1..C.O ggqj
CONTRACTOR: - tA) l�l&#i7s i, PHONE: say -.3 2 - rS3 y
MAILING ADDRESS: AU, I2Li(67 SPp/�fFAJIs IA)4 qct-1-0.7
ARCHITECT/ENGINEER: A p PHONE: - -
MAILING ADDRESS: /V/R-
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:
r ,
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