2003, 03-27 Permit App: 03002028 Fire Damge RepairProject Number: 03002028 Inv: 1
4
Application
Date: 3/27/2003 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FIRE DAMAGE REPAIR TO RESIDENCE Contact: CAPSTONE CONSTRUCTION
Address: 2917 E FRANCIS
C - S - Z: SPOKANE, WA 99216
Setbacks: Front Left: Right: Rear: Phone: (509) 468-4981
Group Name:
Project Name:
Site Information:
Plat Key: Name:
Parcel Number: 45184.1206
District: F
Block: 7 Lot: 4
SiteAddress: 8516.E VALLEY WAY
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 38,750 Sy Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Owner: Name: BERTELSON, PAUL W & FAY L
Address: 8516 E VALLEY WAY AVE
SPOKANE, WA 99212
Hold: [1]
Depth: 0 Right Of Way (ft): 0
HOLD FOR FIELD INSPECTION
Operator: RMB Printed By: GMW Print Date: 3/27/2003
Project Number: 03002028 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/27/2003 Page 2 of 3
Contractor: CAPSTONE CONSTRUCTION
Address: PO BOX 388 Phone: (509) 326-0908
NINE MILE FALLS, WA 99026
Building Characteristics
Const Category: Remodel Group: Type:
Building Permit
Firm: CAPSTONE CONSTRUCTION
Nbr Of Dwellings:
Bldg W x D:
Req Parking:
Occupant Load:
x Building Sq Ft:
Handicap Parking:
DescriptionGtr Type Notes
RESIDENCE R-3 VN FIRE
DAMAGE
REPAIR
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Building Height:
Sprinklers:
Critical Materials:
u
El
Stories:
This Application: Total Project:
Su Ft Valuation Sq Ft Valuation
0 $130,000.00 0 $130,000.00
Totals: 0 $130,000.00
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
0 $130,000.00
Fee Amount
$1,045.00
$4.50
$229.90
Permit Total Fees: $1,279.40
Mechanical Permit
Contractor: CAPSTONE CONSTRUCTION Firm: CAPSTONE CONSTRUCTION
Address: PO BOX 388 Phone: (509) 326-0908
NINE MILE FALLS, WA 99026
Item Description
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
Units
1
1
4
1
Unit Desc
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$1.00
$40.00
$10.00
$63.00
Operator: RMB Printed By: GMW Print Date: 3/27/2003
Project Number: 03002028 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Date: 3/27/2003 Page 3 of 3
Contractor: CAPSTONE CONSTRUCTION
Address: PO BOX 388
NINE MILE FALLS, WA 99026
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
CLOTHES WASHER
ELECTRIC HOT WATER TANK
WATER USING DEVICES
Notes:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Units
3
4
1
2
1
1
1
3
Firm: CAPSTONE CONSTRUCTION
Phone: (509) 326-0908
Unit Desc Fee Amount
NUMBER OF $18.00
NUMBER OF $2400
NUMBER OF 56.00
NUMBER OF $12.00
NUMBER OF $6.00
NUMBER OF $6.00
NUMBER OF $6.00
NUMBER OF $18.00
Permit Total Fees: $96.00
Fee Amount Invoice Amount
$1,279.40
$63.00
$96.00
$1,279.40
$63.00
$96.00
Amount Paid
$1,279.40
$63.00
$96.00
Amount Owing
$0.00
$0.00
$0.00
$1,438.40 $1,438.40 $1,438.40 $0.00
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the
provisions of the code or of any other state or Local laws or ordinances.
Signature:
Operator: RMB Printed By: GMW Print Date: 3/27/2003
1:1
II III
SroKARECouKrY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BtILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 59260
509-477-3675
CeUrads
SPECIFIC SITE INFORMATION
Street Address:
SSS/Cv E V y ilii zv4
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description:
❑ Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
0 Relocation
0 Sign
0 Tenant (New/Change)
her
Department Use Only
Water District/Purveyor.
Sewer District/Purveyor
Road width
Setbacks
Front Rear:
Left Right:
School District
Fire District
Zoning
OWNER/APPLICANT INFORMATION
Indi ute who should be wonlan-d renardine ibis pmiea
❑ (Tyner:1 Phone:
J� j
1 u�/ / Fa y r 8 C e ! c%kJ Fax:
❑ Applicant: Phone: 4/6 Y 7 9g/7
Gj q„,.jl4d'C C. ,.2,, T - Fax:
Mailing Address:
6-5-/a. e.14.,//t-7, (Wel-
Mailing Address:
A 0,&x- -3b
Cite, State, Zip
cia9i4b.dV- frli 5 0.'/ Z—
Citi, State, Zip
. '5 /;7 s` -e..-# 9 yoz,;
❑ Contractor Phone ,eri Sri
gCteY .•�. e-C,1-rJ5? l'ax ( r -5V a'l
0 ArchitPhone
ectilingineer
Fax
Mai ing address
io. �� 3g-$-
Mailing address
1, Z -
City, State Zip
9'-7-i/z f4/6 rt//. 99'G.
City, State Zip
\\A State Contractor license # /
Contact name:
PROTECT INFORMATION
Building Information
Building height toeak rr
ZZIWPPl
# of stories
Z-
Main floor sq. ft.
/5-00
Unfinished basement sq. it.
/5;06
l)imcnsions
Total habitable space
7
"///
2.1 floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction hype
Garage sq. ft.
Deck sq. ft.
Cost of project
0e,k
I lent source (electric, gas, ctc.)
cfr✓kwow-.., ,05P -T. 7-4.'s- r.'...--
Manufactured Home '
Sign
width:
Length:
What is the square footage of the sign
face?
I low high is the sign?
Year:
Make: S
# of signs
Area of existing signs
Proposed use
Value
Address
Relocation
Fire Safety
Firm Name
Previous address
Phone
Fire Sprinkler
Tent
Paint booth Fire Alarm
Fireworks display
_
Proposed use
Value
Address
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
st sr/�t 1—y_yt /)
Phone
Will the site be served by a septic system? 0 Yes L1e<
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property? � �
Yes Lc l o
Are there slopes greater than 30°%o on the property? (30 ft rise in 100 ft)
( °'o) 0 Yes 179-<:,
Are critical or hazardous materials used or stored on site?
❑ Yes fir o
Address
Inspector
Phone
❑ Concrete
❑ Welding
❑ Bolting
❑ Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? ❑ No
Ifyes, ident i 0n site plan Z:o ? c4 t. i-ov4,
What is the current property size?
(square feet or acres) 011ebt / :
Is any part of the property within 250 feet of a shoreline?
Ifyes, idents on site plan 0 Yes L o
What is the current use of this property?
st sr/�t 1—y_yt /)
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes L9 o
Will the site be served by a septic system? 0 Yes L1e<
Is any part of the property within a 100 yr flood plain?
Ifyes, identifi, on site plan
0 Maybe 0 Don't know ❑ Yes CEP<
Are or will there be wells located on the property?
Ifyes, identi on the site plan 0 Yes [$-1N o
Are there any wetlands, streams or ponds within 200 feet of the property?
Ifyes, ident' on site plan 0 Yes 111-‹o❑
Is there evidence of fill or excavation on the property? � �
Yes Lc l o
Are there slopes greater than 30°%o on the property? (30 ft rise in 100 ft)
( °'o) 0 Yes 179-<:,
Are critical or hazardous materials used or stored on site?
❑ Yes fir o
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
❑ Yes ❑ No
Is public sewer available to the site? 0 Yes 0 No
Is the property inside the ASA? 0 Yes 0 No
O Yes ❑ 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?
❑ Yes ❑ No
Date Rccen eJ:
Staff Representative:
METHOD OF PAYMENT
VISA <'
❑ CASII CII[CK 0 MN. 0 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
Dim is
E XPI RI :S:
BAN KCARD NUMBER:
AUTHORIZED SIGNATURE:
SUB'1'O'l Al.
TOTAL FEE
MINIMUM PERMIT FEE IS .f3S.ODPLL•' ASE
MAKE CHECKS PAYABLE TO SPOKANE
COUNTY PERMIT CENTER
INSPECTION REPORT
SPOKANE COUNTY
DIVISION OF BUILDING AND CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
PHONE: (509) 477-3675 • FAX: (509) 477-4703
TYPE:
BUILDING
_CRITICAL AREAS
EROSION/SEDIMENT
_FIRE PREVENTION _OTHER:
REPEAT
_SHORELINES
SIGN
DATE: 11— 3 ^03
Property Address: / IAV A Y
Business Name:
Phone:
Contact Person:
VIOLATION / REQUIRED CORRECTIONS
E 4 7 tL "zS
/.497 AT
s
7L / / / LQz 7S Eth6/.4, AiiAiA- ,4T
r 4r ,L',-1 o RE,L.4 1-£.
7--- is , 1,24 sr /24.47 c21-
&' A ��= -✓?
This inspection has been conducted pursuant to the ordinances and laws adopted by Spokane County. Your cooperation in correcting the above-mentioned
hazards and/or violations is appreciated.
The above -listed items must be corrected and will be reinspected on or after
result in further action.
accordingly. Failure to comply may
If you have any questions concerning this inspection or if you feel you the reinspection date is not adequate for compliance, please contact this office at
411-3615.
PAGE / OF l
INSPECTED BY:
BACE INSPECTION REPORT (CR) REVISED 1/99