1994, 08-15 Permit App: 94007872 Sewer •
APPLICATION WORKSHEET • II qq.... 7?407/
[ General Information
Jolfl dress Parcel number i
i o g-o7 g L s I�dXA^)�/ w
WA , K61
owner ,l 5 ov - 1 -5 •'7_____3
Mailing address
72-4 ti , s,G ti i N 0 (._/,...-; t)Race
city
(moo A,-.) (---)A . Ci 00 a--
Site Information
t
Legal Description
Property size Wa ter District Numberot: Uwelli gs Build my
5-0/ X3 5v / I"1 o p►C L xoaawidth 1 /
L one..._. Inspector
Project Information ` •• 2, 0,O
4- kk , l
t se t ten.I 11 P. St�ttiJi� New Addition model IChangeofuse
�1�� is)
I11►1 l i s caoa, E
1�I t�a IC - v
. Building Information i
Dwelling units Occupant load Building height Stones
Budding dimensions Total square[ootage Req'd parking I Handicap parking Sprinkler system I Critical Material
SHeatin.and insulation information R-values
qu
Main Moorfootage breakdown Uncovered/covered deck •eat source
Second Moor Other
Finished basement 1111111111111111111111
Unrintshed basementNiiiiiiiiiMiliiiii
Garage
1
Contractor Information y
Budding contractor
Plumbing contractor
r `1
License number ."- Phone License number Phone
Mailing address Mailing address
City,state,zip amity.state,zip
Heating contractor Other 1 Lender
License number
Phone License number Phone
ai mga ress Mailing address
Cty,state,zip -City.state,zip
PROJECT CONTACT 1'IIONE --
Spokane County Division of Buildings
* 0..,0,.,..,, ‘Ar., 000Pn * anal ac -17c