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1991, 11-06 Permit App: 91007635 MH Spokane County DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET 07 333 - PARCEL NUMBER: JO 71' 77 Bkc /C .21 / '/ J e, 1 /CG Jif crOV e STREET ADDRESS: S /3 in/,'//,,n C f fe S t CITY/STATE/ZIP: Spo/(4 i e k//4 ' 1'Z.2-3 SUBDIVISION: BLOCK: LOT: ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: 1 # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: enc/ S/r /��y ��7me er PHONE: 1(y qv - 732_6" r y MAILING ADDRESS: /2,//_6- V //>/ J4/4,e_ / isqC/ CITY/STATE/ZIP: Va._//e/ k,-I) it/4- C/903 CONTACT: ,4 rk It o r 5/1 e /// 4 //rp e yl e r PHONE: - y f - 7.32- SETBACKS: - FRONT: LEFT: / RIGHT: REAR: PERIIIT USE: Y " Jr R,-t, " /y 7 - CC' y 2 / **************************************************************************** BUILDING INFORMATION _ 7 CONTRACTOR LICENSE NUMBER: CONTRACTOR: PHONE: - - MAILING ADDRESS: 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: Please provide the following information for Energy Code compliance: Space 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 %:____ Below grade walls R Total floor area Floor R of 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: • • • w N < ) ( 2 ) , O /6 "rlil