1992, 06-29 Permit App 92004812 Change Front Door LocationSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: C620� �vCIiV
CITY/STATE/ZIP:
SUBDIVISION•
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA:
# OF BUILDINGS:
OWNER:
F/A: WIDTH:
# OF DWELLINGS:
MAILING ADDRESS:
CITY/STATE/ZIP•
CONTACT:
SETBACKS: - FRONT:
PERMIT USE:
DEPTH: R/W:
WATER DISTRICT:
PHONE: - -
PHONE: -
LEFT: RIGHT: REAR:
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: Q7 C�&r C * roV
CONTRACTOR: /J�� �y S
MAILING ADDRESS:
ARCHITECT/ENGINEER:
MAILING ADDRESS:
PHONE: 9-C-5' -S,�/ -
PHONE: - -
NEW: REMODEL: --'� ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: ---0 ' X 6 (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING:_ if 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
VAULTED CEILINGS
ABOVE GRADE WALLS
BELOW GRADE WALLS
FLOOR
SLAB ON GRADE
R DOORS U
R WINDOWS U
R GLAZING AREA %
R TOTAL FLOOR AREA OF HEATED SPACE:
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:
LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE