1992, 12-08 Permit App 9201080 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF
APPLICATION
OWNER OR AGENT DATE
7sficISS
•
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: 0 5 s, / 7-
CITY/STATE/ZIP: D el r 44/_ 624
SUBDIVISION:
BLOCK: LOT: t[,] ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: /1-- 'DEPTH: R/W:
OF BUILDINGS: / # OF DWELLINGS: WATER DISTRICT:
OWNER:
MAILING ADDRESS:
CITY/STATE/ZIP:
J 9� PHONE: J5 `? - . 2 2(- j`
`I6/2 r7%7i
CONTACT: PHONE: 32)9 - !? / - 7//
SETBACKS: - FRONT:625 LEFT:
PERMIT USE: A-/IW ¶ G
CONTRACTOR LICENSE NUMBER:
5�d
RIGHT: .S " REAR:
BUILDING INFORMATION
- vt 5
CONTRACTOR: G ty T// /, /2%-gG1/c,C4 3 HONE : ,jC/ r - %� / - (p 7//
MAILING ADDRESS: ?`ij/7/,,IJ, KC �,Wa Vy ,cn'
ARCHITECT/ENGINEER: 74<4!4� 145-62 , L) PHONE: 5U5-- p 5 - Q/cY/
MAILING ADDRESS: 7�o,P YG-Wo &'&,C_
NEW: ✓\R/ EMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: l;y) X VC (WIDTH X DEPTH) SQ. FT.: !/// 7a
REQUIRED PARKING: f 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 :?U DOORS U c/d
VAULTED CEILINGS R 30 WINDOWS U t-{0 /,
ABOVE GRADE WALLS R / GLAZING AREA -3 % �7
BELOW GRADE WALLS R /9 TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR
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:
//-07
-7OLi
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LENDER/BOND HOLDER:
ADDRESS
(8— 7 000
CONTACT G� %" l PI AT a m
PHONE
ADDRESS: S 516 6 F L T S
ZONE: 6J2 1
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