1993, 09-21 Permit App: 93008580 Reroof, Remodel II APPLICATION WORKSHEET 11 ILk
Lk General Information
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"Job address 9 7
/5- y71y7 I Parcel number
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Phone
Owner /7 ? 9
Mailing add ss / /4 77,2-c'
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City State Zip
Vic,/<41`t.,
Site Information
Legal Description
Property size Water llistnct
Number of: Dwellings Buildings
Zone
:Inspector.. ROadwtdth
L Project Information ` -ii, • r()or V a.wt.(i
New I Addition 1 Remodl< I Change of use
.Permit Use
LBuilding Information
Dwelling units Occupant load
Building height Stones
Building dimensions 'Total square tootage Req'd parking I Handicap parking Spnnkler system I Critical Material
Heating and insulation information (R—values)
Square footage breakdown Uncovered!covered deck Heat source
MainMoor
Flat ceiling Vaulted ceiling Above grade wall
Second door Other
Below grade wall Floor Slab on grade
Finished basement
Door(u—value) Window Furnace ethcency
Unfinished basement
Total window area %of floor area
Garage
Contractor Information`
Plumbing contractor
Building contractor� `� 2 )
6 079, c"--:o 1'i S71- -(y / License number Phone
Licensece/ numbe(-7•-6
rr / Q Phone
C->O L�.- 6 0?/ " Mailing address
Mailing address
G- a2 2/8 xfc—. .- A"Z.,
City,state,zip
5,-;f0City,state,zip Wil
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2 '2
G 1(2_, !/Y ]l] Other/Lender
Heating contractorort
License number Phone
License number Phone
Mailing address
Mailing address
City,state,zip
City,state,zip
PROJECT CONTACT � /.v `�. G�6�HONE 7/ / F II
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675 7 gl
REGISTERED AS PROVIDED BY LAW AS A virg4
COBS.. :CONT `tti Nr RAIL ,
REGISTRATION NUMBER EXPIRATION DATE
01. SQL ( ..r 09l348 0 1/1 6/94
E- F Lc:FI VF LAT•t. 0.8 i2 8191
LOIF ``;tC ONST CT iO�4'..
27 K E50014AYE,
SPUKA4E WA 99202
SIGNATURE
ISS I BY DEPARTMENT OF LABOR AND INDUSTRIES
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