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1994, 03-07 Permit App 94001754 Re-RoofAPPLICATION WORKSHEET General Information -17 Job addr / 7 / O Parcel number Owner Pi 4�G2/ G &>e/ i • Mailing address . /7 70 w City z1 /2�E/1%G f2CS State Zip��D// Site Information Legal Descnption Property size -Water Distnct Numberot: Dwellings Buildings ;Ins •Roadwidthi, Project Information V LcAPc((or Permit Use 9: 7 Building Information New Addition Remodel Change of use Dwelling units Occupant load Building height Stories Building dimensions Total square tootage Req'd pa flung Handicap parking Spnnkler system Cntical Matenal Square footage breakdown am floor Uncovered / covered deck Second floor Other i•inished basement Unfinished basement liarage Contractor Information Heating and insulation information (R—values) Heat source Hat ceiling Vaulted ceiling Above grade wall Below grade wall Hoor Slab on grade Door (u—value) Window Pumace ettncency l otal window area % of floor area Building contractor G-J4/2 -Plumbing contractor -License num er hone License number Phone Mailing address 'Mailing address City. state. zip 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