1992, 09-02 Permit App 92007172 GarageSPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
Spokane County
DEPARTMENT OF BUILDINGS l)
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
STREET ADDRESS:
INFORMATION WORKSHEET
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CITY/STATE/ZIP: j /242A/t- 1t '
SUBDIVISION: /?7 S
BLOCK: / LOT: /' ZONE: DISTRICT:
LOT AREAL:�cS�,j F/A: WIDTH: DEPTH: R/W:
OF BUILDINGS: / 1 OF DWELLINGS:
OWNER: ii/? /<
-7ac--e-6 .s
WATER DISTRICT:
PHONE: .57" / - %R 7 - 7 jL /
MAILING ADDRESS: /f' / 7 GC 2��T t+ C & tt 2--
CITY/STATE/ZIP:
CONTACT:
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PHONE:,('% - (722/ - 0/
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE:
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BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: C ,3-2 z c L A L J
CONTRACTOR: C / et`%/1 E % 2,A% (--(0--if%5Y/2<<%/ov_fikpHONE:
MAILING ADDRESS: ,t �X /� /!1z`� 9/��/ �-' ✓�
ARCHITECT/ENGINEER: 4C1 PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: -` STORIES: /
BUILDING DIMENSIONS: -' / X / (WIDTH X DEPTH) SQ. FT.: fie.
REQUIRED PARKING: if HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
PLEASE PROVIDE THE FOLLOWING INFORMATION FOR ENERGY CODE COMPLIANCE:
SPACE HEATING TYPE (Check One)
FORCED AIR ELECTRIC
cc? FORCED AIR GAS
6 PROPANE
ELECTRIC BASEBOARD OR WALL MOUNT
HEAT PUMP
OTHER:
FLAT CEILINGS R DOORS U
VAULTED CEILINGS R c- WINDOWS U
ABOVE GRADE WALLS R GLAZING AREA %
BELOW GRADE WALLS R c= TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR R E
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:
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LENDER/BOND HOLDER:
ADDRESS
CONTACT PHONE
CLEMETSON CONSTRUCTION, NC.
CLEMECP088DJ
P.O. Box 13038
Spokane, WA. 99213 Mk Zl 3�
(509) 921-0171
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