1992, 07-09 Permit App: 92005130 Sewer Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3676
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
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: /7•/FM$7G 4 /%2N4
CONTRACTOR:•O ted...
1 PHONE:
MAILING ADDRESS:
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 oh:
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:
•
•
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: