2002, 04-08 Permit App: 02002317 Fire Damage RepairProject Number: 02002317 Inv: 1
Penalties will be
Project Information:
Permit Use: FIRE DAMAGE REPAIR
Setbacks: Front
Application
THIS IS NOT A PERMIT
assessed for commencing work without a permit
Date: 4/8/02 Page 1 of 2
Left: Right:
Rear:
Ww wa,,-3 a..' a 3,3
Contact: MARONICK, GREGORY WILLIAM
Address: 3904 S SKIPWORTH CRT
C - S - Z: SPOKANE, WA 99206-8601
Phone: (509) 892-7826
Group Name:
Project Name:
Site Information:
Plat Key: 003947 Name: CHESTER HEIGHTS
Parcel Number: 453323506 Block: Lot:
SiteAddress: 3904 S SKIPWORTH RD
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: .00 Acres Width: 102
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Review
Permits:
District:
F
Owner: Name: MARONICK, GREGORY WILLIA
Address: 3904 S SKIPWORTH CRT
SPOKANE, WA 99206-8601
Hold: ❑
Depth: 167 Right Of Way (ft): 0
Released Byj
- 02- e4U-1-Sb4- - L-Le-tE h156r
Operator: CKF Printed By: CKF
Print Date: 4/8/02
Project Number: 02002317
"•i
Inv: 1 Application Date: 4/8/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Const Category: Remo
Nbr Of Dwellings:
Bldg W x D:
Req Parking:
del
Building Permit
Firm: OWNER
Phone:
Building Characteristics
Group: R-3 Type: VN
Occupant Load:
x Building Sq Ft:
Handicap Parking:
Description Grp
RESIDENCE R-3
Building Height: Stories:
Sprinklers:
Critical Materials:
This Application: Total Project:
lug Notes Sq Ft Valuation Sq Ft Valuation
VN FIRE 0 $25,000.00 0 $25,000.00
DAMAGE
REPAIR
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Payment Summary:
Permit Type
Building Permit
Totals: 0 $25,000.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Fee Amount
$432.11
Permit Total Fees:
Invoice Amount
$432.11
$432.11 $432.11
0 $25,000.00
Fee Amount
$350.50
$4.50
$77.11
$432.11
IU
Amount Paid Amount Owing
$0.00 $432.11
$0.00 $432.11
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: CKF Printed By: CKF Print Date: 4/8/02
ISI
SPOKANE C0INUY
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:
S. .r--1(.7 y f_'>' �� e
.Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
�l t?�E )GL— FtJL� i 1i1.-1Ac �
_Building Pernut
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
O Sign
O Tenant (New/Change)
O Other
Depai_uilent Use Only
Water District/Purveyor
Sewer District/Purveyor
Road width
-Setbacks
Front Rear
Left Right
School District
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
(�
Inchcak who 3hou/d Ge ronlacted ee�ardtn. thy prTert
Phone:
Ct
t; -1 Hsi ;" c k --
i\ „hog JJrc...
'icty
lir .rare, Zip
�fOK/-I,t_c
❑ Applicant
Mailing Address:
Phone -
Fac:
t)ii
Cin, State, Zip
❑ t:untrac4n
Marling aJJres.
Lai, crate Zrp
Phone
Fac
❑ Architect/Engineer
Phone
Mailing address
Fax
\\A Spate Contractor license =
Cin, State Zip
Contact name -
PROJECT INFORMATION
I- uldutg hcighr to peak
fel/ ‘2e
1)i Men:, ons
Building Information
# otstorics
YZ-
Main floor sr. tt.
( ZC'b70 6
Unfinished basement sy. h.
Occupancc group
Coat. )1- prnicct
Total h.ibitable space
) I Zoc�
2nd floor sy. (t.
Finished basement sq. ft.
( _onst ruction ripe
Garage sy. Ii
1)eck .y tt.
1 Ieat source (electric, gas, ctc
Manufactured Home
Sign
\\'dth.
Length:
V(/bat is the square footage of the sign
face?
I los high is the sign?
Year:
Make:
# of signs
.Area of esisnngsigns
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) O Ycs . No
Are critical or hazardous materials used or stored on site?
0 Ycs No
,Address
Relocation
Fire Safety
I ,nn Name
Previous address
Phone
Fire Spnnkler _
Paint booth __ Fire Alarm
Tent
Fireworks display
Phone
Proposed use
Value
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) O Ycs . No
Are critical or hazardous materials used or stored on site?
0 Ycs No
Special Inspections Required?
Non -Residential Energy Code Compliance?
I ,nn Name
\\hat is the current use of this property?
SI SI- /- / w"'II LK 0i_.) t:: C l_ 1 t L
Phone
\\'ill the site be served by a septic system? O Ycs ._No
Plans Faaminer
Phone
Inspectors_
Is there evidence ot fill or escayanon on the property?
0 Yes A' No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) O Ycs . No
Are critical or hazardous materials used or stored on site?
0 Ycs No
,Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Arc there structures on the property? Cil Ycs O No
If yes, Iden/O, on sae plan
\'('hat is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, ideutl on site plan O Yes J. No
\\hat is the current use of this property?
SI SI- /- / w"'II LK 0i_.) t:: C l_ 1 t L
Is your property in a designated wildlife habitat arca?
O Don't know 0 Ycs M -No
\\'ill the site be served by a septic system? O Ycs ._No
Is any part ot the property within a 100 yr flood plain?
!lyes, identr(y on site plan
Cl Maybe 0 Don't know 0 Ycs Ei.. No
,\rc or will there be wells located on the property?
If pr.r. i /entrfi, on the rile plan 0 Yes _No
Are there any wetlands, streams or ponds within 200 feet of the property.?
fjres, idena(y on siteplan 0 Ycs —No
Is there evidence ot fill or escayanon on the property?
0 Yes A' No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( --------%) O Ycs . No
Are critical or hazardous materials used or stored on site?
0 Ycs No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to thc site? 0 Yes 0 No
Is the property inside the .ASA? O Yes 0 No
OYcs ONo
Is public water available to thc 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 Arca?
OYcs 0 N
Date }teemed:
Staff Repre..man.e
METHOD OF PAYMENT
VISA
❑ (:.\SII ❑ (:III{CK
_'I1CilVEI
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
1).\11::
BANK( :.\RI) Nl'\IFiI{R
1 \PII:I s
\V I I1ORI/,1:1) SIGN \ I RA::
'l'Fv'I ( yl'.\1.
TOTAL FEE
MIN/M1J, f PERMIT FEE/5535.001'1 rasE
>t UJ:: (.1II CI 200 \RLE-. 10?Pols.\\L
colNTv PERMIT 0'. SI}R