1994, 03-16 Permit App: 94002101 PoolProject Information `
Contractor Information
APPLICSTIOM WORKSHEET
General Information
Job address
C.). 3922 woo 4ru ff
Parcel number
1
Owner
Kivr t CRRLSON
Phone
927-00S3
Mailing address
G. 31122 ,00dr.. "FF
Lily
S POK>RiJ e.
State
W N.
ip
°I `lea O(o
Site Information
1
r
Legal Descnption
lot 1 RLoI of Porod r0SKI S'-"
c/< hfdd l,ew
Property sae
lysd)( (OUi 43
Water Uutnct ( }
Number ot:
Uwellmga
Buildings
d(i
Permit Usp
WS -Wt. /Lie \i‘)
�
SWIMMNN�I Poo 1
New
I
Adddsoo
Hemadel
Change ot use
i
Building Information VI
Uwel mg mots
Occupant bad
Budding height
Stones
Buddingmmensions
Iota t squaretootage
Req'd parting
Handicap parkmg
Sprinkler system
Cntcal Matenal
Squaw footage breakdown
Main Moor
Uncovered /cowered deck
Second floor
Other
Fmmhed basement
Floor
Untmdshed basement
Door (u—value)
Garage
Furnace etticency
Heating and insulation information (R—values)
Heat source
Flat ceding
Vaulted ceiling
Above grade wall
Below grade wall
Floor
Slab on grade
Door (u—value)
Window
Furnace etticency
loml window area
% ot floor area
Buddmg contractor
a
Plumbing contractor
License number
14-j
tie2
Phone
License number
Q "�/
Phone
Mailing address
Mailing address
A/6C
City, state, zip
City, state, zip
Heating contractor
Other f tender
License numberQ
1
Phone
License number
Phone
Mailing address
—"`
Mailing address
City, state, zip
City, state, zip
PROJECT CONTACT
PHONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
Today's
date: 3 -► 6 _1,4
ORIGINAL SITE PLAN
Site address: 5 • 3922 \move/i V ff
I'm proposing to build: /JeW Stu irnrn -Ddd
Parcel number or
legal description:
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