1993, 10-01 Permit App 93008947 Re-Roof°I 3-- ScHl
APPLICATION WOR.KSHEET
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Parcel number 4S 1141, 1 1a
General Information
Job address
Owner — t
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Madmg address /
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City
Site Information
State
Phone
Zip
Legal Descnpuon
Property size
Water District
Number ot: Dwellings
Buildings
;Inspector:
Roadwidth.
Project Information
Permit Us, /, 1
1
1 ,' WALL
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New
Addition
"Remodel
Change of use
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Building Information
Dwelling units
Occupant load
Building height
Stones
Building dimensions
1"otal square footage
Req'd parking
Handicap parking
Sprinkler system
(-lineal Material
Square footage breakdown
Mam floor
Uncovered /covered deck
Second -floor
Other
Finished basement
Unfinished basement
Garage
Contractor Information
i
Heating and insulation information (R—values)
Heat source
Hat ceiling
vaulted ceiling
Above grade wall
Below grade wall
Floor
Slab on grade
Door (u—value)
Window
Furnace etficency
1 oral window area
% of floor area
Buil
mg contractor
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Plumbing contractor
Lic
number
6
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License number
Phone
Mai indress ,/�
652�-/(i
Mailing address
City, state, zip
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City, state. zip
Heating contractor
Other / Lender
License number
Phone
License number
Phone
Mailing address
Mailing address
City, state, zip
City, state, zip
PROJECT CONTACT
PHONE
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
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DEPARTMENT 0:,:'LABOR AND INDUSTRIES
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
-: REGISTRATION NUMBER
' EXPIRATION DATE..
CGJ1
-J4MESYF242Kw
05/.14/94
:;
EFFLCT ivE- DATE
05/14./80
STATE OF WASHINGTON
F625-052-000)3-92)