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2005, 01-07 Permit App: 05000086 Fire Damage RepairProject Number: 05000086 Inv: Application THIS IS NOT ATERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: FIRE DAMAGE REPAIR TO RESIDENCE Contact: A-1 GENERAL CONTRACTORS Address: 6410 N MONROE C - S - Z: SPOKANE WA 99208 Setbacks: Front Left: Right: Rear: Phone: (509) 328-3054 Group Name: Project Name: Date: 01/07/2005 Page 1 of 2 Site Information: Plat Key: 001035 Name: GRAHAMS SUB TR 25 & 26 OPP District: Parcel Number: 45171.0709 Block: SiteAddress: 1223 N HERALD RD Location:: CSV Zoning: AGSUB Water District: Lot: Owner: Name: BITTNER, JIM Address: 1223 N HERALD RD SPOKANE VALLEY, WA 99206 Hold: Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 40 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review Information: Review Plan Review Released By Permits: Building Permit Contractor: A-1 GENERAL CONTRACTORS Firm: A-1 GENERAL CONTRACTORS IN Address: 6410 N MONROE ST SPOKANE, WA 99208 Phone: (509) 328-3054 This Application: Total Project: Description am Type Notes So Ft Valuation Sq Ft Valuation RESIDENCE R-3 VB FIRE 0 $800.00 0 $800.00 DAMAGE REPAIR Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE Totals: 0 $800.00 0 $800.00 Units Unit Desc Fee Amount 1 SELECT $69.25 1 SELECT $4.50 Permit Total Fees: $73.75 Operator: DMD Printed By: MT Print Date: 01/07/2005 Project Number: 05000086 Inv: 1 Application THIS IS NOT A'PERMIT Penalties will be assessed for commencing work without a permit Date: 01/07/2005 Page 2 of 2 MUST MEET ALL REQUIREMENTS OF FIELD INSPECTION. Payment Summary::::;::;: Permit Type Building Permit Fee Amount Invoice Amount Amount Paid Amount Owing $73.75 $73.75 $73.75 $73.75 $0.00 $73.75 $73.75 $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 be complied with. Subsequent issuance of a permit shall not be construed to be 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: DMD Printed By: MT Print Date: 01/07/2005