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Home My WebLink About2002, 02-21 Permit App: 02001071 Fire Damage RepairProject Number: 02001071 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 2/21/2002 Page 1 of 2 Project Information: Permit Use: FIRE DAMAGE REPAIR OF POLE BARN Contact: SERVPRO OF SPOKANE VALLEY Address: P.O. BOX 769 C - S - Z: LIBERTY LAKE, WA 99019 Setbacks: Front Left: Right: Rear: Phone: (208) 457-0112 Group Name: Project Name: Site Information: Plat Key: 000501 Name: CORBIN ADD TO GREENACRES District: Parcel Number: 55191.0414 Block: SiteAddress: 111 S LONG RD SPOKANE, WA 99016 Location:: SPO Zoning: UR -3.5 Water District: Area: 0 Sq Ft Nbr of Bldgs: 1 Urban Residential 3.5 Lot: Owner: Name: Address: INGALLS, RICHARD & CHERLYN 111 S LONG RD SPOKANE, WA 99016 Hold: 111 Width: 110 Depth: 332 Right Of Way (ft): 45 Nbr of Dwellings: 1 Review Plan Re 9 001101101.. tome= NNW 01.041114,06 .411111010.".11.S '.11,411/71. 40 "Mak 4. - Operator: RMB Printed By: RMB Print Date: 2/21/2002 Project Number: 02001071 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 2/21/2002 Page 2 of 2 Contractor: SERVPRO OF THE SPOKANE Address: PO BOX 3706 SPOKANE, WA 99220 Const Category: Remodel Nbr Of Dwellings: Bldg W x D: Req Parking: Building Permit Firm: SERVPRO OF THE SPOKANE VA Phone: (509) 283-2283 Building Characteristics Group: Occupant Load: x Building Sq Ft: Handicap Parking: Description Gtr GARAGE U-1 Type Notes VN FIRE DAMAGE REPAIR Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Notes: Payment Summary: Permit Type Building Permit Totals: Type: Building Height: Stories: Sprinklers: ❑ Critical Materials: 0 This Application: Total Project: Sq Ft Valuation Su Ft Valuation 0 $10,000.00 0 $10,000.00 0 $10,000.00 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK Permit Total Fees: 0 $10,000.00 Fee Amount $163.00 $4.50 $35.86 $203.36 Fee Amount Invoice Amount Amount Paid Amount Owing $203.36 $203.36 $0.00 $203.36 $203.36 $203.36 $0.00 $203.36 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 contrued 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: RMB Printed By: RMB Print Date: 2/21/2002 SPOKANE COUNTY PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 SPECIFIC SITE INFORMATION Street Address: `11 Wceec/ Assessor's Tax Parcel Number(s): Legal Description: Project Description: / 1' P.9 i4 - Building Permit O Change in Use O Grading O Manufactured Home Permit D Relocation O Sign Tenant (New/Change) Other Department Use Only Water District/Purveyor. Sewer District/Purveyor Road width Setbacks Front: Rear. Left Right. School District Fire District: Zoning OWNER/APPLICANT INFORMATION 0 Indicate who should be ,ontaded re2ardine this proied 71 ( hence: Phone: 7 / f ' A l Gel / _1 (,i) /(' Fax: Building height to peak ❑ Applicant: Phone: Fax: Nlanlmg Address: / /// s. < c.,i.-L/' 5r Dimensions Mailing Address: 2O11 floor sq. ft. Cin, `tate, Zip / Occupancy group City, State, Zip Garage s.. ft. ca Contractor 1'ht4' /t/Q !�' g 61-0efc cb J� (4(avL Fax ,,T%f •-tt5 7 i ❑Architect/lin},�neer 0/12— Phone Fax Mailing address ) /r �'%/ 47 t /7C. V. / b Mailing address City, State Zip L,&' 711 L4/ , 1,22,4 %'j 0l j Cr,iState Zip \\ A State Contractor license # 5c-?,-- ..7)5i) c 1 07 Contact name: PROTECT INFORMATION Building Information Building height to peak # of stories Ma n Floor sq. ft. Unfinished basement sq. ft. Dimensions Total habitable space 2O11 floor sq. ft. Finished basement sq. ft. Occupancy group Construction type Garage s.. ft. Deck s.. ft. Cost of prof I teat source (electric, gas, etc.) Manufactured Home Sign Width: Length: What is the square footage of the sign face? How high is the sign? Year: Make: # of signs Arca of existing signs Fireworks display Arc critical or hazardous materials used or stored on site? 0 Ycs 0 No Address Proposed use Relocation Fire Safety Finn Name What is the current use of this property? Previous address Will the site be served by a septic system? 0 Ycs 0 No Paint booth Fire Sprinkler Tent Fire Alarm Fireworks display Arc critical or hazardous materials used or stored on site? 0 Ycs 0 No Address Proposed use Value Special Inspections Required? 9 Non -Residential Energy Code Compliance? Finn Name What is the current use of this property? Phone Will the site be served by a septic system? 0 Ycs 0 No Plans Examiner Phone Inspectors: Is there evidence of fill or excavation on the property? 0 Ycs 0 No Arc there slopes greater than 30°% on the property? (30 ft rise in 100 ft) ( %) 0 Ycs 0 No Arc critical or hazardous materials used or stored on site? 0 Ycs 0 No Address Inspector Phone O Concrete O Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Ycs 0 No Ifyes, identi on site plan What is the current property size? (square feet or acres) Is any part of the property within 250 feet of a shoreline? Ifyes, identifi on site plan 0 Ycs 0 No What is the current use of this property? Is your property in a designated wildlife habitat arca? 0 Don't know 0 Ycs 0 No Will the site be served by a septic system? 0 Ycs 0 No Is any part of the property within a 100 yr flood plain? Ifyes, identify an site plan 0 Maybe 0 Don't know 0 Ycs 0 No Are or will there be wells located on the property? Ifyes, yes, ident on the site plan 0 Ycs 0 No Are there any wetlands, streams or ponds within 200 feet of the property? Ifyes, identify on site plan 0 Ycs 0 No Is there evidence of fill or excavation on the property? 0 Ycs 0 No Arc there slopes greater than 30°% on the property? (30 ft rise in 100 ft) ( %) 0 Ycs 0 No Arc critical or hazardous materials used or stored on site? 0 Ycs 0 No DEPARTMENT USE ONLY Is the property in a designated Stormwater Control Area? 0 Yes 0 No Is public sewer available to the site? 0 Ycs 0 No Is the property inside the ASA? 0 Yes D Yes 0 No 0 No Is public water available to the site? 0 Yes 0 No Is the property inside the PSSA? 0 Yes 0 No Is the property located within 1000 feet of a Natural Resource Area? 0 Yes 0 No Date Received: Staff Representative: METHOD OF PAYMENT VISA ❑ C:\SII ❑ CIII?CK ❑ FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD BAN I<(::ARD NUMBI:R: I':SPIItI :S: \U I R)PIzl;D SUBTOTAL TOTAL FEE MINIMUM PERMIT FEE IS $35.07 PLEASE MAKE CIIECKS PAYABLE TO SPOKANE COUNTY PER:HIT CENTER