1992, 08-11 Permit App 92006326 ReRoof-
Spokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: 'Z s) � 7,A,24-•c
CITY/STATE/ZIP:
SUBDIVISION:
BLOCK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
q-7
y 177
/ OF DWELLLINGS: WATER DISTRICT:
OWNER: + . PA-c,c Li. f.cc-s` , S i. ( PHONE:
0 .-'rr,j : Cl x--; L 0oz,.__,_4,..,�- -� L t - L 1 )
MAILING ADDRESS.
CITY/STATE/ZIP: �,�,�
CONTACT : Cj tf
PHONE:
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: I�-ram / /ri_i
-,sSZ
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BUILDING INFORMATION
ALP) C 088 MN
CONTRACTOR LICENSE NUMBER:
CONTRACTOR:k_i>1 c.)g
PHONE: -zt(tB-
MAILING ADDRESS : L Lk z.t t L,, , � COn ZZ 3
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X (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
FORCED AIR GAS HEAT PUMP
PROPANE OTHER:
FLAT CEILINGS R DOORS U
VAULTED CEILINGS R WINDOWS U
ABOVE GRADE WALLS R GLAZING AREA %
BELOW GRADE WALLS R TOTAL FLOOR AREA OF HEATED SPACE:
FLOOR R
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.
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SQUARE FOOTAGE:
MAIN FLOOR
SECOND FLOOR
BASEMENT - FINISHED
UNFINISHED
GARAGE
CARPORT
DECKS
ADDITIONAL AREAS:
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LENDER/BOND HOLDER:
ADDRESS
CONTACT
PHONE