2004, 11-05 Permit App: 04009020 Fire Damage RepairT0'eCbJd ?LLP 8E£ 60;
Project Number: 04009020
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
£S:7T P00! e0 nON
Date: 11/05/2004 Page 1 oft
Project Information: ..
Permit Use: FIRE DAMAGE REPAIR - NEW ROOFING,
FRAMING, INSULATION & WINDOWS
Setbacks: Front Left:
Right: Rear:
Site Information:
Plat Key: Name: FLORENCE SUB
Contact.
Address:
C - S - Z:
Phone:
Group Name:
Project Name:
A-1 GENERAL CONTRACTORS
6410 N MONROE
SPOKANE WA 99208
(509) 328-3054 L A g Ry
District: Nort
Parcel Number: 45153.0701
Block:
SiteAddress. 621 N MCDONALD RD
Location:: CSV
Zoning: UR -3.5
Water District
Arca: 14,792 Sq
Nbr of Bldgs: 0
Review Information:
Urban Residential 3.5
Ft Width: 0
Nbr of Dwellings: 0
RSA I,
Special Reviews/CI ,
Permits:
- c 1;0
Lot:
Owner: Name: SMALL, AARON D & ANNETTE M
Address: 621 N MCDONALD RD
SPOKANE, WA 99216-0924
�R -P5 DCSc. v‘s €t
Contractor: A-1 GENERAL CONTRACTORS
Address: 6410 N MONROE ST
SPOKANE, WA 99208
Description
RESIDENCE
R-3
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Building Permit
Firm: A-1 GENERAL CONTRACTORS IN
Phone: (509) 328-3054
This Application:
Type Nisi Sq Ft Valuation
VB FIRE 0 520,000 00
DAMAGE
REPAIR
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
Operator:
10 39Cd
Printed By
Totals: 0
Units Unit Desc
1 SELECT
1 SELECT
520,000.00
Permit Total Fees:
0.LDV LNOD 1Ca3N39-TV
Print Date:
Total Project:
5q Ft Valuation
0 $20.000.00
0 $20,000.00
Fee Among
S321.25
S4.50
$325.75
11/05/2004
ZLLb-6ZE-609 60:91 1200Z/80/TT
Z0'39tid ZLL7 8E2 60S
Project Number: 04009020 Inv: /
ES:PT P002 80 DON
Application Date: 11/05/2004 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary: ...::::.,;_. •.
Permit Type
Building Permit
Fee Amount Invoicc Amount Amount Paid Amount Owing
5325.75 $325.75
5325.75 5325.75
50.00 5325.75
50.00 5325.75
Disclaimer:
Submittal of this application certifies the owner (or penon(s) authorized by the owner) has both examined and finds the information
contained within to be nye 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: Printed By: Print Datc: 11/05/2004
Z0 39Hd
010178lN00 7Pa3N39-Td ZLL7-8Z6-605 60:91 400Z/80/TT '