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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.