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1992, 11-18 Permit App: 92010126 MH Spokane County DEPARTMENT OF BUILDINGS West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: 3 3 ? 3 3 . 3 / 0 STREET ADDRESS: ci / WI Rat'L=1 CITY/STATE/ZIP: S Po k 0-10 VI/ a 1 SUBDIVISION: 4 L �0 (/ k O VE: BLOCK: / LOT: '7 ZONE: DISTRICT: LOT AREA: F/A: WIDTH:170 DEPTH: /-37 R/W: I OF BUILDINGS: 1 # OF DWELLINGS: / WATER DISTRICT: C Pr IR c E ) `E OWNER: DA CitjE A ki c y PHONE: 'SO — MAILING ADDRESS: 9 I S. V/l L- L () /11 77-6 v CITY/STATE/ZIP: n3 Pei l<' Pr/ �, - 6161.0 '10 CONTACT: A eL_7o C PHONE: — — SETBACKS: — FRONT: LEFT: RIGHT: REAR: PERMIT USE: ****************************************************************************** BUILDING INFORMATION 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: I 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 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. ******************************************************************************* SQUARE FOOTAGE: MAIN FLOOR SECOND FLOOR BASEMENT - FINISHED UNFINISHED GARAGE CARPORT DECKS ADDITIONAL AREAS: ****************************************************************************** LENDER/BOND HOLDER: ADDRESS CONTACT PHONE F:• • o.N1 o � '3 v ! 7©' I L