2002, 06-06 Permit App: 02004494 Repair Residence •
Project Number: 02004494 Inv: 1 Application Date: 6/6/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: REPAIR DAMAGE TO RESIDENCE CAUSED BY Contact: BELFOR CONSTRUCTION
CAR RUNNING INTO IT Address: 10020 E. KNOX,SUITE 100
C -S -Z: SPOKANE,WA 99206
Setbacks:Front Left: Right: Rear: Phone: (509)893-0001
Group Name:
Site Information: Project Name:
Plat Key: 002392 Name: SKYVIEW ACRES ADD District: F
Parcel Number: 45284.1819 Block: Lot:
SiteAddress: 11711 E 32ND AVE Owner: Name: MC MULLEN,THOMAS & LYNNE
SPOKANE,WA 99206 Address: 11711 E 32ND AVE
Location::SPO SPOKANE,WA 99206
Zoning: UR 3.5
Water District: Hold: ❑
Area: 0 Sq Ft Width: 85 Depth: 150 Right Of Way(ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .
Review
Plan Review Rel aced By
Pf
.....11111111111111111111.11-,
Permits:
Operator: RMB Printed By: RMB Print Date: 6/6/2002
r
Project Number: 02004494 Inv: 1 Application
Date: 6/6/2002 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: BELFOR CONSTRUCTION Firm: BELFOR CONSTRUCTION
Address: 10020 E. KNOX SUITE 100 Phone: (509)893-0001
SPOKANE,WA 99206
Building Characteristics
Const Category: Remodel Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height: Stories:
Bldg W x D: x Building Sq Ft: Sprinklers: El
Req Parking: Handicap Parking: Critical Materials: LI
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VN REPAIR 0 $4,000.00 0 $4,000.00
Totals: 0 $4,000.00 0 $4,000.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $88.00
RESIDENTIAL SURCHARGE 1 Y OR BLANK $19.36
Permit Total Fees: $107.36
Notes
..:.........
FIELD INSPECTION IS REQUIRED PRIOR TO PROCEEDING WITH WORK
Payment Summary: .:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $107.36 $107.36 $0.00 $107.36
$107.36 $107.36 $0.00 $107.36
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 he 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 contrued 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: RMB Print Date: 6/6/2002
i
•
I 1PROJECT APPLICATION WORK SHEET
lit SPOKANE COUNTY DIVISION OF BUILDING&CODE ENFORCEMENT
214
1026 WEST BROADWAY AVENUE
Iii' SPOKANE,WA 99260
SPoi Cowry509-477-3675
\ \\\ 'SPECIFIC SITE INFORMATION
o
Street Address: 1,, ,,,\\1\‘
`" ( ( J Z ry C
Assessor's Tax Parcel Number(s):
Legal Description:
Project Description_ at_ eGT,/ I ill 70 1,47.e, 5,,,,....,_
XBuilding Permit 0 Change in Use 0 Grading 0 Manufactured Home Permit
0 Relocation O Sign O Tenant(New/Change) Cl Other
Depaitment Use Only
Water Distract/Purveyor- Sewer District/Purveyor - - • .Road width Setbacks _ - .-
\i •
.. •Front. -Rear • -
School District Fire District: - • - •- Zoning
Lcft Right
OWNER/APPLICANT INFORMATION
El Indicate who;bould be contacted re,ardinA tbir prayed
0 Outlet
❑APPfic Phony.
�0� Re�Ci/l✓Lf Fax: /h.._ C✓ ��
Mailing Address: f=ag
cin,sate,'/.iMailin Address:/P(/(/„ /{ (/zG2 �V /`
0 contractor/7 �\ �
Phone
0 Architect/Engineer Phone
1/J//o( ,7 fax Fax
n
Mailing address
•�/ Mailing address
City,State Zip
City,State Zip
WA State Contractor license# Contact name:
PROJECT INFORMATION
Building Information
Building height iii peak #of stories Main floor sq.ft. . Unfinished basement sq-ft.
Dimensions -1 otal habitable space 2"d floors
sq.ft. Finished basement sq.ft.
Occupancy group Construction type Garage sq.ft.
y Deck sq.ft.
Cost of proicet I teat source(electric-gas.etc)
' s
Manufactured Home Sign
Width: Length: What is the square footage of the sign How high is the sign?
face?
Year Make: #of signs
Area of existing signs
Relocation . _ • Fire Safety-
Previous address
Fire Sprinkler _ Tent
Paint booth_ Fire Alarm Fireworks display
Proposed use Value
•
Special Inspections-Required? Non-Residential Energy Code Compliance?
Firm Name Phone Plans Examiner Phone
Inspectors:
Address
Inspector Phone
O Concrete O Welding O Bolting 0 Reinforcement Address
ADDITIONAL SITE-INFORMATION
Arc there structures on the property? 0 Yes 0 No What is the current property size?
fyes,ideiitz,On tile plan (square feet or acres)
Is any part of the property within 250 feet of a shoreline? What is the current use of this property?
f yes,idenlyi,on site plan 13 Yes 0 No
Is your property in a designated wildlife habitat arca? Will the site be served by a septic system?0 Yes 0 No
0 Don't know 0 Yes 0 No
Is any part of the property within a 100 yr flood plain? Arc or will there be wells located on the property?
Ilyu,
tdent..!fr on site plan If yes.,itlentffi,on the site plan 0 Yes O No
0 Maybe O Don't know O Yes O No
Are there any wetlands-streams or ponds within 200 feet of the property? Is there evidence of fill or excavation on the property?
Eyes,identify on site p/on O Yes 0 No O Yes O No
Arc there slopes greater than 30%on the property?(30 ft rise in 100 ft) Arc critical or hazardous materials used or stored on site?
( _-%1 0 Yes O No
0 Yes O No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area? Is public sewer available to the site? O Yes 0 No
O Yes O No
Is the property inside the ASA? 0 Yes 0 No Is public water available to the site? 0 Yes 0 No
OYes ONo
Is the property inside the PSSA? 0.Yes O No Is the property located within 1000 feet of a Natural Resource Area?
0 Yes 0 No
Date Reared: \i 1(Rrprescntai.sc
METHOD OF PAYMENT
VISA
❑ c: slI 0c111:c1< ❑ . ❑ . 0
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
DATE: EXPIRES:
TOTAL FEE
BANKCARD NUMBER:
MINIMUM PERMIT FEE IS VS00PISASE
7 lORIZL•:I)SIGNATURE:gI::
ALIKE 0fECKS.PAYABLE TO JI'ptaNE
COUNTY Pt=RNIT CENTER