1992, 06-04 Permit App 92004015 Addition, Remodel-VoidSpokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: G''
CITY/STATE/ZIP: 5/ 40/¢� G(///i4•
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: / 30 DEPTH: / 5 7 R/W:
# OF BUILDINGS: # OF DWELLINGS: / WATER DISTRICT: 5/17. Geri i3
OWNER: 1'u5 /4i5r /(-
MAILING ADDRESS: d ve:
PHONE:
sag _ 7- as65
CITY/STATE/ZIP:
CONTACT: PHONE:
SETBACKS: - FRONT: ,yrf LEFT: 5,2 RIGHT:,(‘ REAR: Zr
PERMIT USE:
******, **********,k,k,k** **********************, ******************,k**,k, ***
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: / J# C0 D971,6
CONTRACTOR: / 5,¢ ro/i/5 . PHONE: SO / ��Y - 5,77
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: K CHANGE OF USE:
41.1
DWELL UNITS: / OCCUPANT LOAD: BUILDING HGT: STORIES: �-
BUILDING DIMENSIONS: #& X y3 (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 Electric baseboard or wall mount Propane
Forced air gas Heat pump Other:
Flat ceilings R Doors U
Vaulted ceilings R Windows U
Above grade walls R Glazing area Wo:
Below grade walls R Total floor area
Floor R of heated space
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:
LENDER/BOND HOLDER:
ADDRESS:
CONTACT:
PHONE: