1995, 04-27 Permit App: 95002717 Repair Fire Damage PROJECT NUMBER= 95002717 APPLICATION DATE= 04/27/95 PAGE= 01
****** THIS IS NOT A PERMIT ******
PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT
SITE STREET= 15110 E 11TH AVE • PARCEL#= 45234 .2302
ADDRESS= VERADALE WA 99037
PERMIT USE= REPAIR FIRE DAMAGED GARAGE
PLAT#= 000543 PLAT NAME= CRAIG SUB.
BLOCK= 1 LOT= 2 ZONE= SFR DIST#= F
AREA= F/A= F WIDTH= DEPTH= R/W=
# OF BLDGS= # DWELLINGS= 1 WATER DIST = VERA
OWNER= ARNOLD, ROCKY PHONE=
STREET= 15110 E 11TH AVE
ADDRESS= VERADALE WA 99037
CONTACT NAME= PAT CUMMINGS PHONE NUMBER= 509 326 0908
BUILDING SETBACKS: FRONT= EXIS LEFT= EXIS RIGHT= EXIS REAR= EXIS
****************************** REVIEW INFORMATION *****************************
DEPARTMENT REVIEW REQUIREMENT
BUILDING FIELD INSPECTION lr� n" � st (✓ /L'` Ll >�
COMMENTS:
******************************* BUILDING PERMIT *******************************
CONTRACTOR= CAPSTONE CONSTRUCTION PHONE= 509 467 5330
STREET= PO BOX 388
ADDRESS= NINE MILE FALLS WA 99026
NEW= REMODEL= X ADDITION= CHANGE OF USE=
DWELL UNITS= OCCUP. LD= BLDG HGT= STORIES=
BLDG W X D = X SQ FT= SPRINKLER= N
REQ PARKING= #HANDICAP= CRITICAL MAT= N
DESCRIPTION GROUP TYPE SQ FT VALUATION
REPAIR M-1 VN 8000.00
ITEM DESCRIPTION QUANTITY FEE AMOUNT
RESIDENTIAL VALUATION Y 99. 00
STATE SURCHARGE Y 4 .50
RESIDENTIAL SURCHARGE Y 17 . 82
******************************* PAYMENT SUMMARY ****************************
PAYMENT DATE RECEIPT# PAYMENT AMOUNT
04/27/95 00003428 121.32
TOTAL DUE= . 00 TOTAL PAID= 121.32
PROJECT NUMBER= 95002717 APPLICATION DATE= 04/27/95 PAGE= 02
PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING
BUILDING PERMIT 121.32 121.32 . 00
121.32 121.32 .00
PROCESSED BY: CAROL FRAZIER
PRINTED BY: KATHY CUMMINGS
******************************** THANK YOU ************************************
7
'� APPLICATION INFORMATION 2 `7 )
What is the JOB SITE address? ASSESSOR'S tax parcel number?
;o9 /-1"52. 314--
Legal
)Legal description aVppears on the property deed
OWNER or OCCUPANT Phone
Rec„/C,y 14 R, L/)
Mailing address City,state Zip
/-..5-7/ ' £ I/7W ,SPo, w'9. 99
Who should we contact regarding this project? Phone
What work is being done under this permit?
RE/3(1/4-P/AK Coie4c4
nspiectordistnct ;,,,,,,, Property:slze ...';
N a)
Water district
a a
m
m
Buildin Building height #of stories
57-09,2
Contractor
;:................................ .............................._....... ......._..........;:;; Dimensions TOTAL SQUARE FOOTAGE
.:........::............................................................................................
eN P5TaA/4. a,057
WA State Contractor license# Main floor area Unfinished basement area
P ST-cc /063:r"
Mailing address 2nd floor area Finished basement area
55, 384)
Architect/Engineer Garage area Size of decks,etc.
What is the heat source? What is the cost of your project? O •QQ
Manufactured Horne Si n
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
Relocation Fire Safet
Previous address Fire Sprinkler _ Tent
Paint booth_ Fire Alarm _ Fireworks display
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
I r •
Fuel Storage Tanks Swimming Pool
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license* WA State Contractor license#
Mailing address Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in,its programs or activities.