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1999, 11-17 Permit App: 99011137 ResidenceProject Number: 99011137 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/19 Page 1 of 3 Project Information: Permit Use: RESIDENCE W /GARAGE - GAS Setbacks: Front 15 Left: 5 Right: 5 Rear: 20 Contact: BILL SMITH/WRS & ASSOC Address: PO BOX 14084 C - S - Z SPOKANE WA 99214 Phone: (509) 922-0782 Site Information: JON'. _J rr Plat Key: 005914 Name: DHAENENS SQUARE PHASE II District: F Parcel Number: 45224.4103 SiteAddress: 1419 S AVALON LN Spokane, WA USA 99216 Location:: SPO Zoning: UNKN Unknown Water District: 010 VERA Area: 4,518 Sq Ft Nbr of Bldgs: 1 Nbr of Dwellings: 1 Owner: Name: W.R.S. & ASSOCIATES INC. Address: 0 PO BOX .14084 SPOKANE, WA 99214 -0084 Hold: ❑ Width: 43 Depth: 90 Right Of Way (ft): 30 Review Information: Department Review BUILDING Site Plan Review Comments: BUILDING Comments: ENGINEER UTILITIES Permits: Comments: Comments: Plan Review Approach / Drainage Sewer Review 0334-qt or n-91 r Project Number: 99011137 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/19 Page 2 of 3 Contractor: BILL SMITH Address: P 0 BOX 14084 SPOKANE, WA 99214 Building Permit Firm: W R S & ASSOCIATES Phone: (509) 922 -0782 Building Characteristics Const Category: New Nbr Of Dwellings: 1 Occupant Load: Bldg W x D: x Building Sq Ft: Req Parking: Handicap Parking: Description Grp, Tyne Notes BASEMENT U R -3 VN GARAGE U -1 VN RESIDENCE R -3 VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Contractor: ALLIED HEATING INC Address: 10213 E BUCKEYE LN SPOKANE, WA 99206 Item Description DUCT SYSTEMS GAS WATER HEATER GAS APPLIANCE <= 100,000BTU GAS PIPING HEAT PUMP OR A/C 0 -3 TONS VENTILATING FANS CLOTHES DRYER GAS LOG OR GAS INSERT Building Height: Stories: 1 2508 Sprinklers: ❑ Critical Materials: El This Application: Total Project: Sq Ft Valuation Sq Ft Valuation 1,246 $14,403.76 1,246 $14,403.76 400 $4,800.00 400 $4,800.00 1,262 $78,244.00 1,262 $78,244.00 Totals: 2,908 $97,447.76 2,908 $97,447.76 Units Unit Desc Fee Amount 1 Y OR BLANK $880.00 1 Y OR BLANK $4.50 1 Y OR BLANK $193.60 Permit Total Fees: $1,078.10 Mechanical Permit Firm: ALLIED HEATING INC Phone: (509) 928 -8252 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 3 # OF UNITS 1 NUMBER OF 3 NUMBER OF 1 NUMBER OF 1 NUMBER OF Fee Amount $10.00 $10.00 $12.00 $3.00 $12.00 $30.00 $10.00 $10.00 Permit Total Fees: $97.00 Project Number: 99011137 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/17/19 Page 3 of 3 Plumbing Permit Contractor: ACTION PLUMBING SERVICE Firm: ACTION PLUMBING SERVICE Address: 15412 E SPRAGUE AVE #9168 Phone: (509) 244 -4427 VERADALE, WA 99037 Item Description TOILETS /BIDETS SINKS SHOWERS TUBS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER FLOOR DRAINS WATER SOFTENER WATER USING DEVICES Payment Summary: Operator: JAS Permit Type Building Permit Mechanical Permit Plumbing Permit Notes: OK TO ISSUE SEWER PERMITS FOR BLOCK 1 - LOTS 1 TH 10, BLOCK 2 - LOTS 1 TH 12 PER ROGER 10/23/98 Units Unit Desc 3 NUMBER OF 4 NUMBER OF 2 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 3 NUMBER OF Printed By: JAS Fee Amount $1,078.10 $97.00 $108.00 $1,283.10 Permit Total Fees: Fee Amount $18.00 $24.00 $12.00 $6.00 $6.00 $6.00 $6.00 $6.00 $6.00 $18.00 $108.00 Print Date: 11/17/1999 Invoice Amount $1,078.10 $97.00 $108.00 $1,283.10 Amount Paid $0.00 $0.00 $0.00 $0.00 DO NOT ISSUE SEWER PERMITS FOR BLOCK 3 - LOTS 1 TH 7, BLOCK 4 - LOTS 1 TH 5, BLOCK 5 - LOTS I TH 6 Amount Owing $1,078.10 $97.00 $108.00 $1,283.10 UTILITIES DIVISION N. Bruce Rawls, P.E., Utilities Director A DIVISION OF THE PUBLIC WORKS DEPARTMENT Gary Oberg, Director GENERAL FACILITIES CHARGE (GFC) PAYMENT OPTION SELECTION RECORD PLEASE NOTE: Form must be tilled out accurately and in its entirety, and signed, or a permit will not be issued. Date: / / / /7/4q Plat Name: f04t.f./S4 (..1 Lot No(s): -3 Block No(s): Site Address(es): /V/ 9 s d !r c 7'1 / .v �— Parcel No(s): Owner Name: " /"SS'o c OR Builder Name: Payment Option Selected (Check One): 1. ( ) GFC payment received at issuance of Sewer Connection Permit by Division of Utilities 2. (>4 GFC to be paid at closing. 3. ( ) GFC payment in 24 equal monthly payments upon establishment of Sewer Billing Account. Complete one of the following statements. a. Owner's Statement: I, , understand that I will be billed for the applicable GFC amount in 24 monthly installments. The monthly GFC installments will be added to my monthly sewer service charges. b. Builder's Statement: I, , understand that because I am selecting this option for payment of the GFC, that the purchaser of the home will be responsible for payment of the applicable GFC in 24 equal monthly installments. I agree to formally disclose to potential buyers of the property that the GFC charges will be added to the monthly sewer service billings as soon as billing comments. Owner's or Builder's Signature Date /// /f7 Spokane County, GFC Payment Option Form Division of Utilities Revised 9/13/99 1026 W. Broadway • Spokane, WA 99260 -0180 • (509) 477 -3604 FAX: (509) 477 -4715 TDD: (509) 324 -3166 T 3 &Lock_ 2_ 4.1 atuzus c, t/ AIM 42H2 11111 o P■VIA-LoA) ( ILliq ONT FLANKING'. CONMEN7S- 5