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2002, 06-18 Permit: 02004890 Fire Damage RepairProject Number: 02004890 Inv 1 Application Date: 6/18/2002 Page 1 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: .............................. .............................. Permit Use: FIRE DAMAGE REPAIR Setbacks: Front Site Information: Plat Key: 001866 Name: ORCHARD AVENUE ADD (TR1-228) Left: Right: Rear: Contact: CAPSTONE CONSTRUCTION Address: 2917 E FRANCIS C - S - Z: SPOKANE, WA 99216 Phone: (509) 468-4981 Group Name: Project Name: Parcel Number: 45063.3208 Block: SiteAddress: 3421 N ELTON RD SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Area: 6,108 Sq Ft Urban Residential 3.5 Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Lot: Owner: Name: BAUS, CHERYL L Address: 3421 N ELTON RD SPOKANE, WA 99212 District: Hold: ❑ Depth: 0 Right Of Way (ft): 0 to 10 Review // Permits: Released By: •^� :, Operator: RMB Printed By: RMB Print Date: 6/18/2002 Project Number: 02004890 Inv: I 'Application 6h8/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Contractor: CAPSTONE CONSTRUCTION Address: PO BOX 388 Phone: (509) 326-0908 NINE MILE FALLS, WA 99026 Building Characteristics Building Permit Firm: CAPSTONE CONSTRUCTION Const Category: Remodel Group: Nbr Of Dwellings: Occupant Load: Bldg W x D: Y Building Sq Ft: Req Parking: Handicap Parking: Description Gni Type Notes RESIDENCE R-3 VN FIRE DAMAGE REPAIR Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Notes: Payment Summary: Permit Type Building Permit Totals: Units 1 1 Type: Building Height: Stories: Sprinklers: Critical Materials: 0 This Application: Total Project: Sq Ft Valuation Sq Ft Valuation 0 $60,000.00 0 $60,000.00 0 $60,000.00 Unit Desc Y OR BLANK Y OR BLANK Y OR BLANK Permit Total Fees: 0 $60,000.00 Fee Amount $642.50 $4.50 $141.35 $788.35 Fee Amount Invoice Amount Amount Paid Amount Owing $788.35 $788.35 $788.35 $0.00 $788.35 $788.35 $788.35 $0.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will he complied with. Subsequent issuance of a permit shall not he contrued to he a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: RMB Printed By: RMB Print Date: 6/18/2002