1996, 08-02 Permit App: 96006153 Tear Off, Reroof 0\ 4, Ce (53
Spokane County
y
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: �y f�G
STREET ADDRESS: . 10(.400 1 "!
CITY/STATE/ZIP: pk-ctite 61qQCXa
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: Tu1 W1/1. L.`S ela,de PHONE: - SW- SjSk
MAILING ADDRESS: 1 - 11c, k) 101-k l`OL.( i
CITY/STATE/ZIP: Vtkr‘ _otj j4,y tJGL 1 g LJ S
CONTACT: ---FICJIC SI rYVY1:e--- PHONE: - E8(/-43-7.:1-
SETBACKS:
8(/-4JSETBACKS: - FRONT: LEFT: RIGHT: REAR:
r
PERMIT USE: - Q_XCX)4 � ' /V• �
****, **************, ***********************************************,k********
BUII[LDDIING INFORMATION
QCONTRACTOR LICENSE NUMBER: �1'�� j_tt CY /`
CONTRACTOR: LL.I ttntt �( th PHONE: ? -S 7 - C»7,3_
MAILING ADDRESS: e. a IllSh-kUYLY ke C aL (DOca
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 Coicompliance:
•Space heating type (check one)
Forced air electric Electric baseboard or wall mount Propane
Forced air gas Heat pump Other:
4rw:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area 9/0:
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 gent, 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: