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2002, 10-29 Permit App: 02009646 ResidenceProject Number: 020096-16 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/29/2002 Page 1 of 3 Project Information: Permit Use: RESIDENCE W/GARAGE - GAS Setbacks: Front 36 Left: 36 Right: 10 Rear: 27 Site Information: Plat Key: 006306 Name: Contact: Address: C - S - Z: Phone: Group Name: Project Name: SUMMERFIELD EAST 4TH ADD DOUGLASS, LANZCE 8510 N CRESTLINE SPOKANE, WA 99217 (509) 483-6532 District: H Parcel Number: 46354.9050 Block: 20 SiteAddress: 5207 N BURNS RD SPOKANE, WA USA 99216 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District: 001 TRENTWOOD Area: 13,145 Sq Ft Width: 114 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Lot: 1 Owner: Name: Address: DOUGLASS, LANZCE 8510 N CRESTLINE SPOKANE, WA 99217 Hold: ❑ Depth: 115 Right Of Way (ft): 38 Review Site Plan Review Plan Review Released By: 41. . /7/4)-Z Approach / Drainae ©A P S 6/0 <i t2J5w101- Flood plain J S O Loa - Released By: Sewer Review 9 Operator: JAS Printed By: JAS Print Date: 10/29/2002 Project Number: 020096-16 Permits: Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/29/2002 Page 2 of 3 Contractor: LANZCE G DOUGLASS, INC Address: 8510 N CRESTLINE SPOKANE, WA 99217 Building Permit -- — -- Firm: LANCZE G DOUGLASS, INC Phone: (509) 483-6532 Building Characteristics Const Category: New Group: Nbr Of Dwellings: Occupant Load: Bldg W x D: Y Building Sq Ft: Req Parking: Handicap Parking: Description Grp Type BASEMENT U R-3 VN DECK R-3 VN GARAGE U -I VN RESIDENCE R-3 VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Notes Type: Building Height: Sprinklers: iJ Critical Materials: 11 This Application: Sq Ft Valuation 1,045 $12,85150 120 $939.60 792 $9,504.00 1,045 $68,970.00 Stories: Total Project: Sn Ft Valuation 1.045 $12,853.50 120 $939.60 792 $9,504.00 1,045 $68,970.00 Totals: 3,002 $92,267.10 3,002 $92,267.10 Contractor: DANCAR MECHANICAL INC. Address: 311 N HODGES RD GREENACRES, WA 99016 Item Description GAS WATER HEATER GAS APPLIANCE<=100,000BTU GAS PIPING VENTILATING FANS CLOTHES DRYER GAS LOG OR GAS INSERT Units 1 1 Unit Desc Y OR BLANK Y OR BLANK Y OR BLANK Permit Total Fees: Mechanical Permit Fee Amount $8}8.75 $4.50 $186.73 $1,039.98 Firm: DANCAR MECHANICAL INC. Phone: (509) 924-9921 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 3 # OF UNITS 4 NUMBER OF 1 NUMBER OF 1 NUMBER OF Operator: JAS Printed By: JAS Permit Total Fees: Fee Amount $10.00 $12.00 $3.00 $40.00 $10.00 $10.00 $85.00 Print Date: 10/29/2002 Project Number: 020096-16 Inv: 1 Application Date: 10/29/2002 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Contractor: GOLD SEAL MECHANICAL INC Plumbing Permit Finn: GOLD SEAL MECHANICAL INC Address: 5524 E BOONE AVE Phone: (509) 535-5944 SPOKANE, WA 99212 Item Description TOILETS/BIDETS SINKS TUBS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER CROSS CONNECTION DEVICES WATER USING DEVICES Notes: Payment Summary: Permit Type Building Permit Mechanical Permit Plumbing Permit Units Unit Desc 2 NUMBER OF 3 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 3 NUMBER OF Permit Total Fees: Fee Amount Invoice Amount $1,039.98 $L039.98 $85.00 $85.00 $78.00 $78.00 Fee Amount $12.00 $18.00 $6.00 $6.00 $6.00 $6.00 $6.00 $18.00 Amount Paid $0.00 $0.00 $0.00 $78.00 Amount Owing $1,039.98 $85.00 $78.00 $1,202.98 $1,202.98 $0.00 $1,202.98 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 be 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 construed 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: JAS Printed By: JAS Print Date: 10/29/2002 APPLICATION INFORMATION What Is the JOB SI fE address ASSESSOR'S lax parcel number? ' /It- 52-4C',7 VSvS Legal description as it appears on the property deed OWNER or OCCUPANT Phone Lanzce G. Douglass, Inc. 509-483-6532 Melling address tally, state Zlp 815 E. Rosewood Ave. Spokane, WA 99208-5507 Who should we contact regarding (his project? Phone Lanzce G. Douglass 509-483-6532 What work is being done under this permit? Single Family Lone Inspector drstnct Property size "Right o1 way width ,. . . t t Water district *'SEE ATTACHED ENERGY CALCULATIONS*, r Building <'....... 936 split Weal- side Building height # of stories , Contractor Lanzce G. Douglass. Inc. Dimensions -&b-x24 55'52 TOTAL SQUARE FOOTAGE WA State Contractor license # LANZCGD072P5 Main floor area -9-3-6- /0q6— ,143,-7--Z0y0 Unfinished basement area 6 we -is -- Mailing address 815 E. Rosewood Ave. 2nd floor area 0 Finished basement area 0 Archilecl/Engineer Independent Home Designs Garage area -7G72 Size of decks, elc. 120 Oover30" Whet is the heat source? fnrrPri ai r Whet is the coat of your project? Manufactured Home Sign . Width: Length: What is the square footage of the sign face? How high is the sign? Year: Make: Installer Contractor We State Contractor license # We State Contractor license # Mailing address Mailing address Relocation -Fire Safety Previous address Fire Sprinkler Tent _ Paint booth Fire Alarm Fireworks display _ _ _ VALUE Contractor Contractor WA State Contractor license # WA Stale Contractor Ilcense # Mailing address Mailing address Fuel Storage Tanks Swimming Pool ICIrcle one) Above -ground Underground Size / gallons Private Contents of tank(s) Size / gallons Public/semi-private Contractor Contractor Wa Slate Contractor license # WA State Contractor license # Mailing address Mailing address COMPLETE ALL APPLICABLE INFORMAT Spokane Co,.rnty does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities, at '?.JU =7N SPOKIAN COUNTX UTILITIES DIVISION A DIVISION OF THE PUBLIC WORKS DEPARTMENT N. Bruce Rawls, E. tJ1jes Director GENERAL FACILITIES CHARGE (GFC) PAYMENT OPTION SELECTION RECORD Gary Oberg, Director ii‹. PLEASE NOTE: Form must be filled out accurately and in its entirety, and signed, or a permit wi71 not be issued. Date: /b -75?-72— Plat Na PC,0*-11 Site Address(es): cw Owner Name: pee— Lot No(s): Block No(s): Parcel No(s): 146-, .c105 -CD . OR Builder Name: PRINT Owner's Name PRINT Builder's Name Payment Option Selected (Check One): 1. ) GFC payment received at issuance of Sewer Connection Permit by Division of Utilities 2. (,X') GFC to be:paid at closing, at the GFC rate in effect at the time of closing. 114. 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 commences. Special Conditions: ) No ( ) Yes — See Reverse Side of Form Spokane County, GFC Payment Option Form Division of Utilities Revised 03/06/00 1026 W. Broadway • Spokane, WA 99260-0180 • (509) 477-3604 FAX: (509) 477-4715 TDD: (509) 324-3166 13' WIDE BORDER EASEMENT 115. 36.0' BUILDING SETBACK 91 10' WIDE EASEMENT FOR UTILITIES IDEWALK LE 9..9 TYPE B CURB QUEEN + AVE. 18+00 RIGHT OF WAY This site plan is being Obfainino a building pe prOsentatibn of the p litiesltlitehgibnS, curb' have been identified. t -Pg. are wetlands, bodies of water, steep Ei2QtZc3o9aal areas. IE yk,=2030.9 e Or RIGHT OF WAY STA: 17+52 16.5' INSTALL TYPE 1 CURB INLET it's ur os oL=2034.1 6 C. il9 � c . kttq a,d por�relct ute�'a easements J W 1 w J 1 1 0 0 2 TYPE B CURB 0 STA: 14+65 16.5' L RIGHT OF WAY INSTALL TYPE 1 CURB INLET EL=2035.36 STA: 14+75.0 OFFSET: 23.7 L INSTALL TYPE A DRYWELL. RIM=2035.25 SCALE: 1 "=30' LOT 1, BLOCK 20 AERFIELD EAST 4th ADD. �•• ENGINEERS o SURVEYORS 1220 H. HOWARD ST. SPOKANWA 99201 FAX (509) 326-0423 (509) 328-5139 101 TRAIN RD. LEWISTON. ID 63501 FAX () 748-6825 (202086) 746-2661