1992, 06-03 Permit App: 92003968 Reroof Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: // / 2
STREET ADDRESS: �9 )z L3 _
CITY/STATE/ZIP: Ice h42-
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER/iDISTRICT:
J ,J 1/ g -"/O2� S2- 7
OWNER: (��(CY�/�l 'r( (��`-'''S� PHONE: [
MAILING ADDRESS: 625Oç5,4 2 h e'r\--�
CITY/STATE/ZIP: . G>1(Q ,LE A),71- ,629c
CONTACT: PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: 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:
r-- '
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:
Fiat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area 0/0:
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: