1992, 03-12 Permit App: 92001494 Sewer Spokane Countyp
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
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PARCEL NUMBER: -sz-/ a --a?D 81
STREET ADDRESS: /c 7/7 .2/ f 7-
CITY/STATE/ZIP: S-~/4/477, c//qL,
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: �# OF DWELLINGS: WATER DISTRICT:
OWNER: /L U.f.rE'GL /�9 /e,m/.B.B • PHONE: ,c01,9 -xe„2 - ep2 77
MAILING ADDRESS: dE=/c 7/ 7 ,2/
CITY/STATE/ZIP: ..j/O/e2A/ C
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:
Please provide the following information for Energy Codercomciance:
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 floor:
Basement- Finished:
Unfinished:
Garage:
Carport:
Decks:
Additional Areas: