1992, 07-13 Permit App: 92005194 Sewer Spokane County
DEPARTMENT OF BUILDING & •SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 4564675
INFORMATION WORKSHEET
PARCEL NUMBER: �-5' ?y'� /9O
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION: Sar.► 'r°/ ��cs-� ���
BLOCK: Y LOT: cr ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
* OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: 27 ,44 PHONE: — —
MAILING ADDRESS:
. CITY/STATE/ZIP:
CONTACT: PHONE: --
SETBACKS: — FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
1 CONTRACTOR LICENSE NUMBER: "47 u.) D Ac 2/7f'Z
CONTRACTOR: i1//1" ,e" PHONE:
MAILING ADDRESS: 952/7 / 74;',4
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: 4 HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
lease provide the following information for Energy Code compliance:
•
•pace 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 oh:
Below grade walls.R Total floor area
Floor R of heated space
Slab on grade R Furnace efficiency rating
'lease indicate on your plans:The location of the radon vent,and the location of the vent fan area.
Square footage
Aain floor:
second floor.
3asement— Finished:
Unfinished:
3arage:
carport:
•
Decks:
Additional Areas:
•
•
•
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: