1991, 10-14 Permit App: 91005340 RemodelSpokane County
DEPARTMENT -OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: _A 4q6 (A)ood la. un
CITY/STATE/ZIP: S,2&ko-ry
SUBDIVISION:
BLOCK:
LOT:
ZONE:
DISTRICT:
LOT AREA:
F/A:
WIDTH:
DEPTH: R/W:
# OF BUILDINGS:
# OF DWELLINGS:_
WATER DISTRICT:
OWNER: Illtcha�e-(
V: (t(J'L,)
VS
PHONE: 90
MAILING ADDRESS:
L4 4 L�T
W (ppp�L �, (a-
u-)
CITY/STATE/ZIP:
t)
/
CONTACT:
SETBACKS: - FRONT: LEFT:
PERMIT USE
CONTRACTOR LICENSE NUMBER:
PHONE:c�b9 Cla �-GC 3�Z
RIGHT• REAR:
BUILDING INFORMATION
CONTRACTOR: PHONE:
MAILING ADDRESS•
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF OSE:
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 EFiergy 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 -
Additional Areas: