1992, 06-03 Permit App: 92003986 Window Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: / 7 7
CITY/STATE/ZIP: 6 ,e P e vg rS /g S 4 990/6
SUBDIVISION:
BLOCK: LOT: ZONE:_____ DISTRICT:
LOT AREA: ,3 F/A: /4 WIDTH: DEPTH: R/W:
# OF BUILDINGS: ' # OF DWELLINGS: / WATER DISTRICT: CoA/folid' 7 c(
OWNER: i ,A/A/4 W Se// o Th. PHONE: .S-0 - 9-26 -
MAILING ADDRESS: 7 2 0 6 C / 7-
\ • CITY/STATE/ZIP: Qi c A/i4 C P 45 u1- c 4 9 907 G
\ CONTACT: pi, N o.k t dY PHONE: - g -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: toZro
**** *********** ** ************ *, **************** *********************
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:
Please provide the following information for Energy 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— Finished: •
Unfinished:
Garage:
Carport:
Decks:
Additional Areas:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: