1991, 11-07 Permit App: 91007656 Sewer Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: =77.(//
STREET ADDRESS:
CITY/STATE/ZIP: ' � P^ to
SUBDIVISION: 6;0 ,",a tY 2;r r) 7 /)
BLOCK: '/ LOT: / ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: r Y ' t' fir ;, PHONE: — —
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE: — —
SETBACKS: — FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: (C. L -.S' '" 4
CONTRACTOR: / 1'4 .4"fr ' r:, , — 2
e^ PHONE• ("://, ....
MAILING ADDRESS: C '5 77:CC.. lilt if . tee" ., 4 . a
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 Codes comsOliance:
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 0'o:
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: