2001, 01-02 Permit App: 01000036 Fire Damage RepairProject Number: 01000036 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/2/01 Page 1 of 2
Project Information:
Permit Use: FIRE DAMAGE REPAIR/RECONSTRUCTION
Setbacks: Front
Left: Right: Rear:
Site Information:
Plat Key: 000000 Name: UNKNOWN
Contact: SERVCO ENTERPRISES
Address: 730 N COLUMBUS
C - S - Z: SPOKANE, WA 99202
Phone: (509) 489-5952
Group Name:
Project Name:
District: F
Parcel Number: 45163.0409
Block:
SiteAddress: 10921 E NIXON AVE
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 15,514 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Department Review
BUILDING „ iew--
easons:
Permit Conditions:
Permits:
Lot:
Owner: Name: PERRY, VALARIE
Address: 10921 E NIXON AVE
SPOKANE, WA 99206-7218
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Project Number: 01000036 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/2/01 Page 2 of 2
Building Permit
Contractor: SERVCO INC Firm: SERVCO INC
Address: 730 N COLUMBUS Phone: (509) 489-5952
SPOKANE, WA 99202
Building Characteristics
Const Category: Remodel Group: R-3 Type: VN
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: 111
Req Parking: Handicap Parking: Critical Materials: 0
This Application: Total Project:
Description Grp Type Notes Si] Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN FIRE 0 $75,000.00 0 $75,000.00
DAMAGE
REPAIR
Item' Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Payment Summary: wavarWMKSIMEMIMMAMEW#inEM
Operator: MKC
Permit Type
Building Permit
Totals: 0 $75,000.00 0 $75,000.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Printed By: MKC
Fee Amount
$902.73
Permit Total Fees:
Print Date:
Invoice Amount
$902.73
$902.73
Notes: z-
$902.73
Fee Amount
$736.25
$4.50
$161.98
Amount Paid
$0.00
$902.73
1/2/01
Amount Owing
$902.73
$0.00
$902.73
I dc I
Alit
SPox<CouNrY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675 Cf l — 3
SPECIFIC SITE INFORMATION
Street Address:
/09L!E. Al i mi
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
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Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant (New/Change)
O Other
OWNER/APPLICANT INFORMATION
El Indicate who should (contacted renardine this proiect
0 Owner:yy Phone:
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Mailing address
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WA Statetractor license #
_SE v c_-_1,7 (339Pe_
Contact name:
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OWNER/APPLICANT INFORMATION
El Indicate who should (contacted renardine this proiect
0 Owner:yy Phone:
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Fax
Mailing Address:
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Building height to peak
Mailing Address: /
50 ,U. (D/u
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City, Sta Zip
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Dimensions
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Deck sq. ft.
Phone
Fax
Mailing address
73-0 it) Col aniu c
Mailing address
City, State G
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City, State Zip
WA Statetractor license #
_SE v c_-_1,7 (339Pe_
Contact name:
PROTECT INFORMATION
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..., "rs. x. r#,.. ff-.....�
Building height to peak
# of stories
Main floor sq. ft.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2nd floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project�J -61-1)
O -`
/S, l/t,t/ 0 t j�)
Heat source (electric, gas, etc.)
ktN'b�c2�' S� $ ,,{4*'St
�� auric x 0 5
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Width:
Length:
What is the square footage of the signs
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
Previous address
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
Firm Name
Phone
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
O Concrete 0 Welding 0 Bolting 0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes 0 No
If yes, identify 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?
If yes, identf on site plan 0 Yes 0 No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 0 No
Will the site be served by a septic system? 0 Yes 0 No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
0 Maybe 0 Don't know 0 Yes 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes 0 No
Are there any wetlands, streams or ponds within 200 feet of the
property?
Ifyes, identify on site plan O Yes 0 No
Is there evidence of fill or excavation on the property?
0 Yes 0 No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
(/ %) 0 Yes 0 No
Are critical or hazardous materials used or stored on site?
0 Yes 0 No
DEPARTMENT USE ONLY
Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASH ❑ CHECK ❑ NOME ❑
'€lC Vf':
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
EXPIRES:
AUTHORIZED SIGNATURE:
SUBTOTAL
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Date Received:
Staff Representative:
METHOD OF PAYMENT
VISA
❑ CASH ❑ CHECK ❑ NOME ❑
'€lC Vf':
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE:
BANKCARD NUMBER:
EXPIRES:
AUTHORIZED SIGNATURE:
SUBTOTAL