1992, 08-14 Permit App 92006446 Demo-VoidSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: / {>J C (d Z= , s40h i-v 4
CITY/STATE/ZIP: S4PQi?6 ).. 'w 4 9 `/ )
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT:
OWNER: a 0 .n/ ) U R S .� PHONE: S (; `1 - `)J< 1 -
MAILING ADDRESS: / -)) c) (.
CITY/STATE/ZIP: S PDXANL v, 9 9-Q/ V
CONTACT: (-c:2, %' .v A v t� PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: 47- n"1 e_)
******************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:
MAILING ADDRESS:
PHONE:
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:
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.
*******************************************************************************
SQUARE FOOTAGE:
MAIN FLOOR
SECOND FLOOR
BASEMENT - FINISHED
UNFINISHED
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
******************************************************************************
LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE
I41 O(& moAtWAy me.
EEAtrGEL Mo. 1443- 112
t w.aL 17E5GIZIPTIOf`!:
170'
Io' lo' 1o'
1.1.W, Ye' of W, Yz Ex4LU2IUv
t, FT: TRACK #83 VERA.
LJO TH
Iq = COI
70'
5f"E 7LA J
zG19PT; I2+IU fiEn
fi 1 loco 6.e.L e priL TAW.
::1I7EWALK,
J
I?inr)nnWAV