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 /
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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:
•
•
•
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