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1995, 01-19 Permit App: 95000279 Repair Fire Damage A •� PROJECT NUMBER= 95000279 APPLIC.ATIO1.1 DATE= 01/19/95 PAGE= 01 ****** THIS IS NOT A PERMIT ****** PENALTIES WILL BE ASSESSED FOR COMMENCING WORK WITHOUT A PERMIT SITE STREET= 11213 E 43RD AVE PARCEL#= 45333. 1106 ADDRESS= SPOKANE WA 99206 PERMIT USE= FIRE DAMAGE REPAIR TO TRUSSES PLAT#= 000877 PLAT NAME= FOREST MEADOW 1ST ADD BLOCK= 2 LOT= 6 ZONE= SFR DIST#= E AREA= 00018360 F/A= F WIDTH= DEPTH= R/W= # OF BLDGS= # DWELLINGS= 1 WATER DIST = UNKNOWN OWNER= JUTTE, GLEN PHONE= 509 926 0961 STREET= 11213 E 43RD AVE ADDRESS= SPOKANE WA 99206 CONTACT NAME= PAT PHONE NUMBER= 509 326 0908 BUILDING SETBACKS: FRONT= NA LEFT= NA RIGHT= NA REAR= NA ****************************** REVIEW INFORMATION ***************************** DEPARTMENT REVIEW REQUIREMENT BUILDING FIELD INSPEC. REQ PRIOR PERMIT CV___ 1 I). COMMENTS: 19 .q ******************************* 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= 1 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 R-3 VN 25500. 00 ITEM DESCRIPTION QUANTITY FEE AMOUNT RESIDENTIAL VALUATION Y 258 .50 STATE SURCHARGE Y 4 .50 RESIDENTIAL SURCHARGE Y 46. 53 ******************************* PAYMENT SUMMARY **************************** PAYMENT DATE RECEIPT# PAYMENT AMOUNT 01/19/95 00000388 309. 53 TOTAL DUE= .b0 TOTAL PAID= 309. 53 PROJECT NUMBER= 95000279 APPLICATION DATE= 01/19/95 PAGE= 02 PERMIT TYPE FEE AMOUNT AMOUNT PAID AMOUNT OWING BUILDING PERMIT 309.53 309.53 . 00 309. 53 309.53 . 00 PROCESSED BY: DAWN DOMPIER PRINTED BY: KATHY CUMMINGS ******************************** THANK YOU ************************************ s. ~ ( 2 // APPLICATION INFORMATION ( 3 What is the JOB SITE address? ASSESSOR'S tax parcel number? iii H ; 3 15 . '-1-3 nee. . Li A., Legal description as it appears on the property deed OWNER or OCCUPANT _ Phone G /— KO SUIT 9z6-,---(..)76/ Mailing address City,state Zip 2D• ) I a 1 - if. i-1- S1t) k►4,)ji, ).1")( 99db 6 Who should we contact regarding this project? Phone 014 P STZ?/u,C1 Ceevo57 `( P4`T. 1 3 .6'' o 76 S What work is being done under this permit? .Cone nspecoistrict ; e.:. 'Hightat way Httthy . Water district a) O g Buildin Building height #of stories Contractor j 5' "2 I Dimensions TOTAL SQUARE FOOTAGE A-4(1s TCNL ClIN.s7- '32)s _5-.5-- WA State Contractor license# Main floor area _ Unfinished basement area Mailing address v 47 J S ) 2nd floor area Finished basement area ?o. 3�k /�3e6 7 fit/// �/4cl s 0,21- �b'iJL- .3Lk��C Architect/Engineer Garage area Size of decks,etc. What is the heat source? ZZ 3 / ,- Lk LGA What is the cost of your project? As r-�,�,�, � .2-5;57)6, `e' &5.5 Manufactured Home 5 i r 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 Safety Previous address Fire Sprinkler Tent _ Paint booth Fire Alarm Fireworks display Contractor VALUE Contractor WA State Contractor license# A State Contractor license# Mailing address Mailing address Fuel Storage Tanks Swimming Piot (Circle one) Above-ground Underground Size/gallons Private Contents of tank(s) Size/gallons Contractor Public/semi-private Contractor Wa State Contractor license# WA State Contractor license# Mailing address Mailing address COMPLETE ALL APPLICABLE INFORMATION