1991, 09-16 Permit App: 91005803 GarageSpokane County �;1' 7 s�
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: �� /� OD Z 74 ,,4te,,
CITY/STATE/ZIP:�?d�f4l�-� �C{/
SUBDIVISION: S� tl (1 l-
BLOCK: LOT:ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH:/S-/S/ R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER:/P103 �io �bijE' � PHONE:
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: 3, LEFT: S RIGHT: REAR: SUS
PERMIT USE:
BIIILDING INFORMATION
.a
CONTRACTOR LICENSE NUMBER: 5 cv i+O? c ,*o y 6 3
CONTRACTOR: �f�ifEs�lcJ���.z Soh PHONE:
MAILING ADDRESS: /?U ?ox-
ARCHITECT/ENGINEER:
o X
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE: — --
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BIIILDING HGT: STORIES:_
BUILDING DIMENSIONS X (WIDTH X DEPTH) SQ. FT.: S S L
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 HeQt pump-
Flat
ump
Flat ceilings R _
Vaulted ceilings R
Above grade walls R
Below grade walls R
Floor R
Slab on grade R
Doors U
Windows U
Glazing area__,
Total floor area
of heated space
Furnace efficiency rating
Propane
Other:
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:
VG. PV11.
Decks:
Spokane County
APPROVED AS NOTED:
Additional Areas:
BUILDING AND SAFETY DATE
BY
DATE
BY
ENGINEERING' DATE -
BY
_
TIES DAT
BY( E:
OTHER DATE
BY
NOTES:
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