1992, 12-04 Permit App: 92010605 Residence� s
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS:
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT:
LOT AREA: F/A:
ZONE: DISTRICT:
WIDTH: DEPTH: R/W:
# OF BUILDINGS: if OF DWELLINGS: WATER DISTRICT:
OWNER:PHONE:
MAILING ADDRESS: r 3 3 13 S w
CITY/STATE/ZIP: U .e._r4_c(" (c� 2903 r)
CONTACT:
PHONE: - -
SETBACKS: - FRONT: LEFT::_ RIGHT: // REAR:Ll�l
PERMIT USE:
BUILDING INFORMATION7-
CONTRACTOR LICENSE NUMBER: G lR Y L G ,L Q% yt�i- 1
CONTRACTOR: PHONE: 3f)
MAILING ADDRESS: 3 313 S GV 4 r F' c-- h L ca U e {^r. d a I c � g G -92
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE: - -
NEW:-Z�� 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 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 3 j
VAULTED CEILINGS R
ABOVE GRADE WALLS R�
BELOW GRADE WALLS Rte_
FLOOR R
SLAB ON GRADE R
DOORS U
WINDOWS U
GLAZING AREA %
TOTAL FLOOR AREA OF HEATED SPACE:
3 C 'fJ'
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 z l -I
SECOND FLOOR
BASEMENT - FINISHED
UNFINISHED
GARAGE 7 i
CARPORT
DECKS
ADDITIONAL AREAS:
LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE
Bulling ker
Planning
Engineers
Health
Utilities
Other
i
q � ' ADDRESS: _ 240e 1215
ZONE: I47;f — 4.!1.5 1
ROAD WIDTH:
FRONT: /' FLAN ING:
COMMENTS:
REVIEWED BY:
se
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