HomeMy WebLinkAbout2005, 05-18 Permit App: 05001652 Fire Damage RepairProject Number: 05001652 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/18/2005 Page 1 of 2
Project Information:
MOSAIMMENSINSNMOMINES
Permit Use: FIRE RESTORATION OF HOUSE
Setbacks: Front
Left: Right: Rear:
Site Information: ��„.,NNW
Plat Key: 001838 Name: OPPORTUNITY TR # 01-354
Contact: BELFOR CONSTRUCTION
Address: 10020 E. KNOX, SUITE 100
C - S - Z: SPOKANE, WA 99206
Phone: (509) 893-0001
Group Name:
Project Name:
District: Nort
Parcel Number: 45164.0381 Block:
SiteAddress: 11904 E VALLEYWAY AVE
Location:: CSV
Zoning: AGSUB
Water District:
Area: .00 Acres
Lot:
Owner: Name: BLAUERT, THAD M.
Address: 11904 E VALLEYWAY AVE
SPOKANE VALLEY, WA 99206
Hold: ❑
Width: 90 Depth: 310 Right Of Way (ft): 40
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:
Review
Special Inspections
\V ('2 CW-)G�j-�
Permits:
SUBJECT TO FIELD INSPECTION. DD
Contractor: BELFOR CONSTRUCTION
Address: 10020 E. KNOX SUITE 100
SPOKANE, WA 99206
Building Permit
Firm: BELFOR CONSTRUCTION
Phone: (509) 893-0001
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Su Ft Valuation
RESIDENCE R-3 VB FIRE 0 $25,000.00 0 $25,000.00
RESTORATI
ON
Totals: 0 $25,000.00 0 $25,000.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $391.25
STATE SURCHARGE 1 SELECT $4.50
Permit Total Fees: $395.75
Operator: DMD Printed By: MT Print Date: 05/18/2005
Project Number: 05001652 Inv: 1
Notes:
,Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/18/2005 Page 2 of 2
Payment Summary:
Permit Type
Building Permit
Atm
Fee Amount Invoice Amount
$395.75 $395.75
$395.75 $395.75
Amount Paid Amount Owing
$395.75 $0.00
$395.75
$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: DMD Printed By: MT
Print Date: 05/18/2005
S�kane
40,,Ualley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
• Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: ! 1 90 41 6" \/A t l -7 '4 y SP04A,(C ) o `'
Assessor's Tax Parcel Number(s):
Legal Description:
- n
PERMIT DESCRIPTION: �' (.� E'�� i �—� (.OSte._._
• Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner. l /i ) wt, 13.LAux nom' ❑ Applicant: CONT l?hcTu(C
Phone: Fax: Phone: Fax:
Address: S A c: Address:
City State Zip Code City State Zip Code
O Contractor: j3eaa ft USA 6 edLetD-10- 0 Architect:
Phone: SK 3--0 00 i Fax: Caw 3 -on a a \Phone: Fax:
Address: j o o,o f iC 4 o ,c Address:
SPoiLp,,i-e wA. g93.0 4
City
State
Zip Code
City
State Zip Code
WA State Contractor License #:66 a 6u 40 gel o t3 J Contact: Lola R, e Lre
Spokane Valley Bus. Liscense #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
20
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
¶oo ApRay
214D FLOOR SQ. FTG:
L cca 4Z(
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS: 3
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST `I' OJE T• �
`0 5 , l J
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? "i
J
1
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
•
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash 0 Check 0 Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: