1992, 03-24 Permit App: 92001776 Sewer Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET Li I
PARCEL NUMBER: aR 5444 - D 7 T7
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STREET ADDRESS: E //- yli<-‹ 771-X
CITY/STATE/ZIP: °"Q'"E'� //%.
SUBDIVISION: moo'-rte 7 S 4M€12- (CXnti`)4 J P
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BLOCK: LOT: ZONE: DISTRICT: 3 -
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LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: PHONE:
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: % 4 7---
CONTRACTOR: ' i 1 'mac -- PHONE: - 7 -
MAILING ADDRESS: / fl ' , g/./.
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: