1991, 08-27 Permit App 91005347 Re-RoofSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER: .3 79,/ 9Y,
STREET ADDRESS: e /y5,2/
CITY/STATE/ZIP: � .,� 07)C._ c-a / C'
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
OWNER:
# OF DWELLINGS: WATER DISTRICT:
PHONE:
MAILING
3
MAILING ADDRESS: �'
CITY/STATE/ZIP: r e ii '- / 6-
CONTACT:
SETBACKS: - FRONT: LEFT:
PERMIT USE:
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: Lam,
MAILING ADDRESS:
REAR:
%5� '3
PHONE:
RIGHT:
BUILDING INFORMATION
PHONE: 2'5/ - yoZ -
ARCHITECT/ENGINEER:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
PHONE:
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
Forced air gas
Flat ceilings R
Vaulted ceilings R
Above grade walls R
Below grade walls R
Floor R
Slab on grade R
Electric baseboard or wall mount
Heat pump
Propane
Other:
Doors U
Windows U
Glazing area %:
Total floor area
of heated space
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: