1992, 06-10 Permit App: 92004213 MH Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: L 9- 252. / 1/62- /9/6 611
STREET ADDRESS: a. 9',25-
CITY/STATE/ZIP:
SCITY/STATE/ZIP: �IJo/2<Q-f7(e__ LSA
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: —.� �ey
PHONE: ..5-439 - 64?7 - j2.
MAILING ADDRESS: C IT)Ct S `e/ 2—
.
. CITY/STATE/ZIP: UJ
CONTACT: PHONE:
SETBACKS: — FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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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: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
i
Please provide the following information for Energy Code compliance:
Space heating type(check one) ne
Pro a
Forced air electric Electric baseboard or wall mount Propane
Forced air gas Heat pump
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area `h:
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:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: