1995, 05-05 Permit App: 95002986 Tear Off, Reroof >
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: 45 ( ( 2 —2
STREET ADDRESS: to
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: - F/A: WIDTH: DEPTH: R/W:
I OF BUILDINGS: I OF DWELLINGS: WATER DISTRICT:
OWNER: ; V Fair5 , 13) PHONE: 50"i q2c — 3g31
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE: -
SETBACKS: - FRONT: LEFT: RIGHT: REAR: •
PERMIT USE: 7-e_a_ 4-P
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: bdif..).E, 1\irc. ..Ey PHONE: 509 — 2 2: 7-7
MAILING ADDRESS: , <c)„ Q 71C * ..4) 4 L.,
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENS]ONS: X (WIDTH X DEPTH) SQ. FT. :
REOUIRRn PAPKTNG # HATHITCAP! SPRTNYCLERRn! riRTMTC*AT MhMVOTRT .
♦1 n_
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 II.
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.
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SQUARE FOOTAGE:
MAIN FLOOR
SECOND FLOOR
BAS a IN - FINISHED
UNFINISHED
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
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LENDER/BOND HOLDER: .
ADDRESS