2004, 12-06 Permit App: 04009331 Fire Damage RepairProject Number: 04009331 Inv: I
Application Date: 12/06/2004 Page 1 of 2
THIS IS
NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
Project Information:
..
Permit Use: FIRE RESTORATION-BEDROM
Contact CAPSTONE CONSTRUCTION
W/STRUCTURAL DAMAGE & SMOKE
DAMAGE Address: PO BOX 388
RESTORAT
C - S - Z: NINE MILE FALLS, WA 99026
Setbacks: Front Left: Right Rear:
Phone: (509)4684981
ION
Group Name:
Site Information:
Project Name
Plat Key: 999999 Name: RANGE
District: Sout
Parcel Number: 45213.9272 Block:
Lot:
SiteAddress: 10708 E 10TH AVE
Owner: Name: HARRINGTON, KELLY
Address: 10708 E 10111 AVE
Location:: SPO
SPOKANE, WA 99206
Zoning: AGRI
STATESURCHARGE
Water Dmaict,
Hold: ❑
Area: .00 Acres Width: 0
Depth: 0 Right Of Way In): 0
Nbr of Bldgs: 1 NbrofDwellings: 1
Review Information:
_.
Red -'
Spc
Permits:
-- Building Permit '---
Contractor: CAPSTONE CONSTRUCTION Firm: CAPSTONE CONSTRUCTION
Address: PO BOX 388 Phone: (509) 326-0908
NINE MILE FALLS, WA 99026
Operator: DMD
Total Project:
So Ft Valuation
0 $10,000.00
0 $10,00200
Fee Amount
$18L25
$4.50
This Application:
Description GM Type
Notes
So Ft
Valuation
RESIDENCE R-3 VB
FIRE
0
$10,000.00
12/06/2004
RESTORAT
ION
Totals:
0
$10,000.00
Item Description
Units
Unit Dese
RESIDENTIAL PERMIT FEE
I
SELECT
STATESURCHARGE
I
SELECT
Operator: DMD
Total Project:
So Ft Valuation
0 $10,000.00
0 $10,00200
Fee Amount
$18L25
$4.50
Permit
Total Fees:
$185,75
Printed
By:
MT
Print Date:
12/06/2004
Project Number: 04009331 Inv: 7 Application Date: 12/06/2004 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Nates:
Parment.Summarr:
Permit Type
Fee Amount Invoice Amount
Amount Paid
Amount Owine
Building Permit
$185.75 $185.75
$18575
$0.00
$185.75 $185.75 $185.75 $0.00
Disclaimer.
Submittal of this application certifies the owner (or person(s) authorimd 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 regulationsgoverning 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: 12/06/2004