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