1992, 10-12 Permit App: 92008756 Sewer Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: ,-
STREET ADDRESS: 15 1 DSO J- l y = 4 e
CITY/STATE/ZIP: k0b (. . ) ? 174. 7
SUBDIVISION: vv
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: if OF DWELLINGS: WATER DISTRICT: �j^
OWNER: 6.1file 1 M 1 A 1x1^,cdC. PHONE: Sb Itle - 1 4 7
MAILING ADDRESS: P.D. AaNk. Sly"-
CITY/STATE/ZIP:
l5"-CITY/STATE/ZIP: Vt_r'.!LCL t. , r, cyciC.Y17
Ke
1 1`'- PHONE: - t - 40.1qCONTACT: V�� Asa V\
�
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: 1 HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
PLEASE PROVIDE THE FOLLOWING INFORMATIOI, FQR ENERGY CODE COMPLIANCE:
SPACE HEATING TYPE (Check One)
FORCED AIR ELECTRIC ELECTRIC BASEBOARD OR WALL MOUNT
FORCED AIR GAS HEAT PUMP
PROPANE OTHER:
FLAT CEILINGS R DOORS U
VAULTED CEILINGS R WINDOWS U
ABOVE GRADE WALLS R GLAZING AREA
BELOW GRADE WALLS R TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR R
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.
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SQUARE FOOTAGE:
MAIN FLOOR
SECOND FLOOR
BASEMENT - FINISHED
UNFINISHED
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
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LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE