1992, 08-03 Permit App: 92006004 Reroof Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: K6-02 2% ^ /O7/v?
STREET ADDRESS: E . 13-70y - 51 6r 14 V-e.
CITY/STATE/ZIP: D1�a/l 6.1 a)6 J q Z Ie.p
SUBDIVISION:
BLOCK: /o? LOT: a ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
it OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
\ OWNER: (1-4- F7. 5 ��Q e e b, eeiA s C.. PHONE: 501 - krSTRICT:
\ 1-1
ADDRESS:
CITY/STATE/ZIP:
I) 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:
r
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 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