1992, 04-06 Permit App: 92002175 SewerC/ a - �y73
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
cf,�S '3/O INFORMATION WORKSHEET
PARCEL NUMBER• �57
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
# OF BUI"LLDDIN�GS�:_r /y# OF
DWELLINGS:_ WATER DISTRICT: UPn �,-
OWNER: 1 IT-C_e✓ Lh�l PHONE:
MAILING ADDRESS: �nnJ 3 c73 I6
CITY/STATE/ZIP:
CONTACT:
BLOCK:
LOT:
ZONE:
DISTRICT:
SETBACKS:
LOT
AREA:
F/A:
WIDTH:
DEPTH:
R/W:
# OF BUI"LLDDIN�GS�:_r /y# OF
DWELLINGS:_ WATER DISTRICT: UPn �,-
OWNER: 1 IT-C_e✓ Lh�l PHONE:
MAILING ADDRESS: �nnJ 3 c73 I6
CITY/STATE/ZIP:
CONTACT:
PHONE:
- -.
SETBACKS:
- FRONT:_
LEFT:_
RIGHT:_
REAR:_
PERMIT
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER
MAILING ADDRESS
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE:
PHONE:
NEW:_ REMODEL:_ ADDITION:_ CHANGE OF USE:_
DWELL UNITS: OCCUPANT LOAD: BUILDING MGT: STORIES:
BUILDING DIMENSIONS: K
REQUIRED PARKING:_ # HANDICAP:
(WIDTH K DEPTH) SQ. FT.:
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
Basement - Finished:
Additional Areas:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT: PHONE: