1991, 08-07 Permit App: 91004816 ReroofSpokane -Count ;,;,. .°,,,x°'
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA, 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
21( 53`(- 67?
STREET ADDRESS:
7/
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CITY/STATE/ZIP: S orn/✓e vvJ ki 95`„t/ t
- SUBDIVISION:
20155
BLOCK: 9 LOT: S ZONE: DISTRICT:
LOT AREA: F/A:
# OF BUILDINGS:
(yt
OWNER: /,2A4o 1e to ccc-
WIDTH:
# OF DWELLINGS:
MAILING ADDRESS: 7/A7 67 `/
DEPTH: R/W:
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WATER DISTRICT: z/454 m5 r o n'
PHONE: D - 777- ,F940
CITY/STATE/ZIP: ti p,(4 -,e.¢ -"ICAO PY',Z/'r_
CONTACT: t7 TR(ii tJ
SETBACKS: - FRONT:
LEFT:
PHONE :/item c - 9A7 -'m$7%'.
RIGHT:
PERMIT USE: 4GU /6c j)(' /OyS/a4)73--
REAR:
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_...-BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE: -
NEW: REMODEL:_ ADDITION:_ CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT:
BUILDING DIMENSIONS:
X
STORIES:
(WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
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Please provide the following information for Eneigy Code compliance:
4 ...t-s'Y4 ..
Space heating type (check one) rr,.. , ;
Forced air electric Electric ba,seboard 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 ratin
�a:
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:
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