1981, 11-17 Permit: 81B-1916 Fire Damage RepairPLAN NUMBER APPLICATION/PERMIT
PERMIT NUMBER
SPOKANE COUNTY —� BUILDING CODES DEPARTMENT
�, l
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
* * 1 n 0
APPLICANT: COMPLETE NUMBERED SPACES — PRESS
HARD TO MAKE 3 COPIES
JOB ADDRESS
Ih
LEGAL DESCRIPTION — SEE ATTACHED
1
I i
LO
O
BLOCK
JSUBDIW I
fON
PARCEL NUMBER/S 67
n
* 1 (� 1, u Y
OWNE
PHONE
3.
ADDRESS
ZIP
Actual Set Backs in Feet
�� ��
North South
East West
i 1 - '1 7
6 �j 9
COJV R CT
►
PHONE 0
Size of Parcel Zone Classification
4' ADkkDy�t'� ESS
��
p—
TyCroonst.
iV
ccupancy
Sprinklered
IA"i
❑Yes ❑No ❑ Req'd.
DESIGNER
PHONE
Valuation
Building Area in Sq. Ft.
5.
—
ADDRESS
ZIP
Main Floor
Upper Floors I
Garage Area
Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished Basement
Unfin. Basement
6.
TYPE ❑ EW ALT. ❑ AD'N. ❑ RPL. ❑ MVE.
No. Baths
No. Stories
No. Rooms
No. of Dwellings
7, OF �/ ❑OTHER
CERTIFICATE
Req'd.
I Recd.
Not q'd.
WORK 111111dLL BLD. ❑ PLMB. ❑ MECH. ❑ M.H. ❑POOL
of EXEMPTION
DESCRIBE WORK Enum. Dist. Location (Area)
FEES COLLECTED
8
VAL ATION SOURCE GAS ELEC RIC WATER SEWER USE CODE
Ownership
,e ��
9. 2 �i UTILOITIES Public ❑ Privatee&
I
Single $
1 hereb certify that I have read and examined this application and have read the "NOTICE" provisions incjded
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governinguiding
type of work will be complied with whether specified herein or not. The granting of a permit does not pr
to give authority to violate or cancel the provisions of any other state or local law regulating construction
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS Plumbing
L
DATE OF APPLICATION`—"'� SIGNATURE OF APPLI Mach.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
Env. Health
Kblf IV--)
" SEPA
Planning
Fire Marshall Mobile Home
Other (Specify)
Utilities (1
TOTAL $ v `
Plansminer
nr �M
IN THIS SPACE,
WHEN MACHINE VALIDATED
SEPA Checklist THIS BECOMES A PERMIT.
' Tech cia PERMIT IS NONTRANSFERABLE 1 `l�t1- 7"_.8/' l�.
191,625 * 14 H.0:°a` -
October 30, 1981
Dave Sitton
E. 11924 Railroad Ave.
Spokane, WA 99206
RE: Fire Damage
Dear Mr. Sitton;
SPOKANE COUNTY
DEPARTMENT OF BUILDING & SAFETY
BUILDING -PLUMBING - MECHANICAL - FIRE
811 N. JEFFERSON SPOKANE, WA. 99260-0050
TELEPHONE : 456-3675
JAMES L. MANSON, DIRECTOR
Our office has received information that a recent fire resulted in damage
to your residence located at East 11924 Railroad.
A building permit is required from our office for any work to be done to
repair or replace this structure, as per Section 301 (a) of the Uniform
Building Code which states: "It shall be unlawful for any person, firm
or corporation to erect, construct, enlarge, alter, repair, remove, improve,
convert or demolish any building or structure regulated by this code, or
cause the same to be done without first obtaining a separate permit for
each building or structure from the building official".
This permit must be obtainedrp for to commencing with any of the work which
is described in Section 301. If a permit has not been obtained within 30 days
of the receipt of this letter, please contact us within that 30 day time period
and notify us of your intentions regarding this structure.
A special inspection can be made to assist you in the evaluation of the damage
caused to this structure by the fire. If you should desire this inspection,
please call our office at 456-3675. The fee for this inspection is assessed
at a rate of $16.00 per hour.
If you should need any additional information, please call our office at the
above mentioned phone number.
Sincerely,
Jeffrey Forry
Building Technician
JF:ss
e
10
FDID I cident No
to D o _I Ilk
` Correct Address I Number
Occupant_Nage
Owner Name
WASHINGTON STATE
FIRE INCIDENT REPORT
FIRE DEPARTMENT
Exp � Month � Day •Vear ��
Dir Name
Address
Insurance Agent uur
!7
rE-1-M of Alarm Irom Public (Check appropriate Code Number Belowii
,-Telephone Direct to F D 6 -No Alarm. No Response
2 -Municipal File Alarm Coded �"ll Telephone Tie Line
3 -Private F A System k -1 -Municipal F.A.. Voice Signal
4 -Radio __ 9 -Not Classified
_
5 -Verbal _ _ __ 0-Undetermmed/Unreported
'F -1 -Type of Action Taken: (Check appropriate Code Number Below)
yt'(:xtingutshment __ 4 Remove Hazard _7 Emerg Med.
2 Rescue Only 5 Standby - 8 Move -Up
3 Invest Only 6 Salvage - 9 Not Classified
Comment_. _ _ _ ___0 Undetermined
G-1 No Fue Personnel Used at Scene G-2 No Engines G-
Day of Week
Layou; 2 —1. Delete
902 F IRevrsed 9-801 —2. Change
- O
r Alarm Time in Service
Type Zip Code Census Tract
Telephone Room or Apt
- -
/Y
_65 Farm complex.
Telephone
c - 7 .Fn
E -2 -Type of Situ eund:
r to Code "E-2" and list the specific
Code Number in the space Below.
1 Fire. Expl, I% 1� 1
4 Haz Cond
11 7 False L 1
2 Pressure Rupture L 1
5 Ser. Call 1
1 1
3 Rescue I I I
6 Good Intent I
1 I 9 Other I 1
F-2 Company
No F-5 Mutual
F-6 RCW 48.48 REOUIREMENT
Insp DistrictAlarms
Aid
K -2 -Form of Heat at Ignition: (Refer
to Code "K-2" and list the specific Code Number)
I Recd
_1 State Fire Marshal Notified
4--F-4
/ 2 r.
NA
12061 763 3605
It. Telephone CMlectl
! 6 Special Equipment
I _.IIBJ
fuel Powered Object l I 14
— IGII
o Aerial Apparatu
No. Other Vehicles
�24
l Fire Marshal Notified
5 Hot Object I 1 9 Other Form of Heal
IQ-
.-3 Police/Sheriff Notified
_-_
--
CAUSE OF FIRE ICheckJ
H-1 Incident Related Injuries Fire Service OthersH-2 Incident Related
(Also complete Form 902-G) — 110 c. �r I 1 G 1 C ( r Fatalities
f H-3—Complex (Check appropriate Code Number fisted below)
Fire Service Others_ __4 Suspicious —6 Undetermined
- , - --I ;i-," it —5 Arson ,7-7 Not Applicable
11 Public recieation complex. parks
_.42. Apartment complex.
_65 Farm complex.
12 Sladimn. exhibition hall complex. sports.
_... 44 Hotel complex. motels. inn. lodges
- 66 Indian reservation complex
14 Club complex golftennis. etc
_ 47 Mobile home park complex.
- 70 Industrial plant, manufacturing complex
1-3 20 Educational complex schools colleges
___58 Shopping complex dept stores. malls
__80 Warehouse. storage complex
33 Medical care complex hospitals. mental
_. 59 Office complex, incl non-military
—91. Construction complex, incl demolition
34 Prison complex
govt complex.
—93 Campsite complex
40 Business with residential complex
.__ 61 Power production complex
___94 Waterfront complex marinas
.95 Railroad transport complex
_96. Road complex. highways. streets
_97 AirporN. sof complex
No complex
If other properties meeting the definition
for a complex are identified they may bf
indicated by Complex Code 99
41 Dwelling complex lone and two-family). _ 63 Military reservation defense complex.
s
I.
1-1—Fixed Property Use: (Refer to Code I' and list specific Fixed Property Use' Code Number)
I-2—Mobile Properly Use: (Refer to Code 'I" List 'Mobile Property Use Code No I
-1 -.8
1 Pub Assem Plop ; j_ _1 1 5 Store, Oil Prop Lim -_I 8 Storage Prop. I I I I
1 Passenger Road Trans I_1J 5 Air Trans. Veh 1 1
DZ
2. Edu Property '...._1 ..1 6 Basic Ind. LIN 9. Special Prop I 1 1 I
2 Freight Road Trans. 1 1 I 6 Heavy Equipment I I
2 Function Areas
3. Inst Property 1L..J Det. Property I I 1 1
3 Rail Trans. Vehicle 1 I I 7 Spec. Veh. Containers I IT
3 Func Areas (cont I
4. Res Property _J 7. Manu) Prop. I_L_-I
4 Water Trans. Vessel I I I 9 Other Mbl. Prop. Types Irtt!Q�
rAn
J -1 -Area of Fire Origin: (Refer to Code "J-1list Code Number( J -2 -Level of Fire Origin: (Check the appropriate Code Number)
J -3 -Termination Stage: (Check appropriate Number)
0 Means of Egress
J 5 Service Facilities I _-! J -1 Grade Level to 9 it above _6 Over 70 it above
-1 -.8
1 Assem . Sales Areas
,L_ _ J 6 Sery Equip. Areas Ij_J _2 10 to 19 feet above _.7 Objects in flight
_ 9 Termination stage no
2 Term in smolder stage classified above
(Glml s of people]
p p
7 Structural Areas I t _ 3 20 to 29 feet above -8-Below ground or water level
__J_, etore flame. __0 Termination stage
30 to 49 tee; above 9 Level not classified above Terminated /unreported.
2 Function Areas
8 11ansp . Veh Areas L__1__J -4 _-
in or undeter
3 Func Areas (cont I
_ 9 Other Areas of Origin) _)__J ---5 5010 70 feet above ._0 Undetermined/Unreported
after flame stage.
4 Storage Areas
j
0 Undetermined/ Unrepoi led
0 K-1 -Equipment Involved
in Ignition Ill anyl: (Refer to Code '-K-1' and Inst the specific Code
K -2 -Form of Heat at Ignition: (Refer
to Code "K-2" and list the specific Code Number)
Z Number-)
L2
1 Heal from Fuel Fired,
3 Smoking Material 1 1 7 Natural Source I I i
0 1 Healing Systems
� g y
! 6 Special Equipment
I _.IIBJ
fuel Powered Object l I 14
Open Flame. Spark I 1 18 Hostile Fire Exp. I I_J
= 2 Cooking Equipment
7 Processing Equipment 1 I I
2 Elect. Equipt. Arcing.
5 Hot Object I 1 9 Other Form of Heal
_LZ 3 Au Conti Refers
_ . ,: _-j
_L- _. 8 Service. Mamt. Eguipt. I -I
Overload L-- _J
6 Explos Fireworks I t I of Ignition t I
-a 4 Elect Dist Equipl
,. J 9 Other Object. Exposure Fire Lam_
0
C 5 Appliances Equrpt
Origin: iA,Ier to Codes F and 0 and list
L -1 -Type of Material
Ignited: ;Refer to Code 'L-1" list Code
L -2 -Form of Material Ignited: (Refer to Code "L-2" list Code
L-3-Ignitlon Rotor: (Refer to Code --L-3" list Code Numberl
Number)
-
Number)
1 Incendiary L. -J -.J 6 Design. Construction.
1 Gas
L_ i 6 Wood. Paper L. -_L__;
1 Strucl. Comp_ Finish!_I J 6 Power Trans Equrpt_
2 Suspicious I___J Instal Deficiency I I
2 Flammable Comb
7 Fabric. Textile. Fur ,__. j_J
2 Furniture L 1 J Fuel j� _J
3 Misuse. heat or Ign. IBJ 7 Oper. Deficiency I I I
Liquid _
1 8 Material Compel
3 Soft Gd_ Wear API. L ,_L__J 7 General Form L_ I J
4 Misuse. Mat Ignited IL _; 8 Natural Condition 1 1
3 Volatile Solid Chem ;I
___j with Oil I1_—J
4 Adrnment. Rec- Mat L-.l___j 8 Special Form 1-1
5 Mech. Failure. Mall. L 1 I 9 Other Ignit. Factor I
4 Plastic
...1 9 Other Types
5 Suppliers. Stock L_.L—J 9 Other Form material I_LJ
5 Natural Product Ij_-.;
of Material L. I
M 1 -SL uclure Type ICneck the appropriate Code Number)
'; t Iidg w/one Fixed Prop use
6 Open Platform
A 2 Budding 2 F P uses plus
7 Underground Structure
3 Open Stiurlme
8 Not a Structure
4 Au Support Structure
9 Type Not Classified
5 Tent
0 UndelerminedlUnreported
1
v
M-2—Construction Type: (Check the appropriate Code Number)
_.._1 Fite Resistive __6 Unprolect Ord.
._ 2 Heavy Timber /l7-Prolect Wood Frame
—3 Prot Noncomb Limit Comb _ 8 Unprolect Wood Frame
4 Unprol Noncomb not Ouab- __ 9 Not Classifed above
_ tied as No 3 above ._0 Undetermined /Un-
5 Protected Ordinary reported
M-3—Construction Method: (Check appropriate Code Number)
e,-i-Sde Built Structure __4 Factory Bit Mobile
_ 2 Factory Bill . Site Assem —9 Not Classified above
_3 Factory 811 Modular __0 Undetermined/Unreported
0.2—Deleclor Performance (Check Appropriate Code Number)
N1 N2. N3 01 -Damages IC ecki _ _
1 Detectorisr in room or space of fire ongm—operated
0
N2 N3
OJ
wDamage
Confined to: Flame Smoke Water
Control
'
oc
1 Oblect or Ong,n 1 1 1
1
is
2 Rnom!area ongm 2 2
2
de'
3 Room of a g.n 3 3 3
3
0 Undetermined/ Unrepoi led
4 Fire Rated Cnnlpurt 4 4 4
4
lo-
5 From of O,rgin 5 5 5
5
L2
6 Succlwe of Ongrn J/6 ,iC 6
1-BNo,e alarm 5-1019 minutes
8 Material Compounded
7 Fxtenderl Beyond
9 -No Dollar Loss
rS'r
,hire of O•rgln 7 7 7
7
W
8 Nor a Si,,;chne Fire 8 8 8
8
Q : �. CL �..)1-
n.6.6. 4 c 10 DOD S24 999
9 No Damage of this Type 9 9
9
0
W
0 Undele;m ,Unreported 0 0 0
0
11 Flame or Smoke Spread Beyond Room of
Origin: iA,Ier to Codes F and 0 and list
ire specific mali generat:nq the Most
Flame d,rd the material gene,alrrlg the
Most Smoke as wen as avenues of "Frame
i,a,el and Smoke Travel List specific
code items m Ine appy opt tale spare provided
to columns P 1 '0-1 P2 and 0.2
1
v
M-2—Construction Type: (Check the appropriate Code Number)
_.._1 Fite Resistive __6 Unprolect Ord.
._ 2 Heavy Timber /l7-Prolect Wood Frame
—3 Prot Noncomb Limit Comb _ 8 Unprolect Wood Frame
4 Unprol Noncomb not Ouab- __ 9 Not Classifed above
_ tied as No 3 above ._0 Undetermined /Un-
5 Protected Ordinary reported
M-3—Construction Method: (Check appropriate Code Number)
e,-i-Sde Built Structure __4 Factory Bit Mobile
_ 2 Factory Bill . Site Assem —9 Not Classified above
_3 Factory 811 Modular __0 Undetermined/Unreported
0.2—Deleclor Performance (Check Appropriate Code Number)
0-3—Sprinkler Performance ICneck appropriate Code Numbers)
1 Detectorisr in room or space of fire ongm—operated
--I Equipment Operated
,--netectorts) not in room or space of fire migin—operated
--_2 Equipment should have but did not operate
_ 3 Detector in room or space o1 fire origin—did not operate
-3 Equipment present/fire too small to activate
_ 4 [)elector not in room or space o1 fire oriom—did nor operate
�gNo equipment present in room or space of fire origin
._ 5 Delector(si in room of bre origin but fire too
—9 Performance of A equipment not classified
small to operate
above
-. 8 No detectors present
_0 A S Performance undetermined /unreported
9 Performance of lire detectors not classified
A,$ Confined lire
0 Undetermined/ Unrepoi led
—
P -I
Material Sen.
Q-1 Material Gen.
Avenue W
p 2 Smoke Travel
Most Flame
Most Smoke
1 Gas
— -2 Corridor
Travel IL J
2 Flam Comb Liq
3 Structural Horizontal
Stanwell
3 Volatile Solid Chem
L _1 - J
_r__J
4 Plastic
L
_ 7 Utddy Open Floor
5 Nalural ProduC1
I
9 Other Factor
6 Wood Paper
S 3-7ime from Alarm r Aped applicatwl
_0 Undeter/Unreporied
7 Fabric Textile Fur
B-St000 000 plus_
1-BNo,e alarm 5-1019 minutes
8 Material Compounded
2- 51005999 �4- S50 000 5249999
9 -No Dollar Loss
*,In Ort
q
3-SIDDOS9999-S250ODO5999999
'7
9 Other Material Ignited
/
0-Undetermmed/Unreported
A S Extinguished fire
veer
Avenue of
P4 flame Travel
Avenue W
p 2 Smoke Travel
1 Interior Finish L_y i
_ 1 Air Duct
2 Structural Vertical
— -2 Corridor
Travel IL J
— 3 Elevator Shalt
3 Structural Horizontal
Stanwell
Travel _t
-_ 5 Opening Const,
4 Physical Material
—6 Util Opening Wan
Ignited _ _;
_ 7 Utddy Open Floor
5 Building Contents�jNo
s�grubcant Travel
9 Other Factor
ot Classified
9 '00"C'
S 3-7ime from Alarm r Aped applicatwl
_0 Undeter/Unreporied
- R --Method of Extinguishment (Cbrck I':p,opndir Code N,u,'oer belowi
veer
Make
1 Sen F.bngwahed 4 Acicmanc E.hng,� SN"i; System
6 P:eConnea LrnetWalrr from hydrant standpipe draft
_ 9 Not Classified Above
2 Make Shift Aids �%'lirr Co—cr Line Appa, Tank
7 Hand hose Liner Water from hydrant standpipe or draft
- 0 Unoetel mined I Unreported
in - 3 Portable E.I,ngursh r e. Ia,rk Capauty .� No lanksl
W
8 Master Stream Devises With or Without Hand Lines
so
r..
Q
Year
Make
Model
W S 1 S 2 And S-3 rCheck ine appropriate lode N-ir!iris listed belox.i
Voltage pl allyl
40
T
.a S-1-Estimaltd S 2- Property Damage Classification
S 3-7ime from Alarm r Aped applicatwl
T
r
St to 599 5-525000 519999
B-St000 000 plus_
1-BNo,e alarm 5-1019 minutes
8-Ove60 minutes q
2- 51005999 �4- S50 000 5249999
9 -No Dollar Loss
_ 2 -less 2 minutes 6-20.39 minutes
_ 9 -No appi necessary
3-SIDDOS9999-S250ODO5999999
'7
0-UndeleiiUmepofted
3-25 minutes 7-4060mmWes
0-Undetermmed/Unreported
Q : �. CL �..)1-
n.6.6. 4 c 10 DOD S24 999
-6 9 minutes
Assignment
Date
T -2 -Member Making Report -if not Officer In Charge Date
(Name Pos,hon Assignmen �s
veer
Make
Model
Serial No
License No (of any)
30
Year
Make
Model
Sena) No
Voltage pl allyl
40
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(13A'51 -f /; &-, -0)