2002, 10-29 Permit App: 02009645 ResidenceProject Number: 020096-15 Inv: I
Application
Date: 10/29/2002 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 36 Left: 30 Right: 6 Rear: 27
Site Information:
Plat Key: 006306 Name: SUMMERFIELD EAST 4TH ADD District: H
Contact: DOUGLASS, LANZCE
Address: 8510 N CRESTLINE
C - S - Z: SPOKANE, WA 99217
Phone: (509) 483-6532
Group Name:
Project Name:
Parcel Number: 46354.9050 Block: 20
SiteAddress: 5215 N BURNS RD
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District: 001 TRENTWOOD
Lot: 2
Owner: Name: DOUGLASS, LANZCE
Address: 8510 N CRESTLINE
SPOKANE, WA 99217
Hold: ❑
Area: 11,250 Sq Ft Width: 197 Depth: 118 Right Of Way (ft): 38
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Released By: /2-Z // //
Approach / Drainage
[Released By:
e LO
Flood plain
Released Bv:
O SLA) 103
Sewer Review
Operator: JAS
Printed Bv: JAS
Print Date: 10/29/2002
Project Number: 020096-15
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
Const Category: New
Nbr Of Dwellings:
BldgWxD: x
Req Parking:
Building Permit
Firm: LANCZE G DOUGLASS, INC
Phone: (509) 483-6532
Building Characteristics
Group: Type:
Occupant Load: Building Height: Stories:
Building Sq Ft: Sprinklers: ❑
Handicap Parking: Critical Materials: E
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,045 $12,853.50 1,045 $12,853.50
120 $939.60 120 $939.60
792 $9,504.00 792 $9,504.00
1,045 $68,970.00 1,045 $68,970.00
Description Grp Type Notes
BASEMENT U R-3 VN
DECK R-3 VN
GARAGE U-1 VN
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STA CB SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: DANCAR MECHANICAL IN
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
Totals: 3,002 $92,267.10 3,002 $92,267.10
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$848. 75
$4.50
$186.73
$1.039.98
C. Firm: DANCAR MECHANICAL INC.
Phone: (509) 924-9921
Units
1
1
3
4
1
1
Operator: JAS Printed By: JAS
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$3.00
$40.00
$10.00
$10.00
$85.00
10/29/2002
Project Number: 020096-15 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
Firm: 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 $1,039.98
$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 TE address? ASSESSOR'S tax parcel number?
/&"— Z ( c)(71'_5
Legal description as it appears on the property deed
LOT Z BLOCK 70 ,..t5c1-1.10-f-Pef ► "Y ,�►_,/'
OWNER or OCCUPANT Phone
Lanzce G. Douglass, Inc. 509-483-6532
Mailing address City, state Zlp
815 E. Rosewood Ave. Spokane, WA 99208-5507
Who should we contact regarding thls project? Phone
Lanzce G. Douglass 509-483-6532
What work Is being done under this permit?
Single Family
'
Zone • ,.. ..
Inspector district
Properly size
Right of way width
Water district
*SEE ATTACHED
ENERGY CALCULATIONS***
t
wBuilding'
936 split14/g 'side
Building height
# of stories
1
Contractor
Lanzce G . Douglass. Inc.
Dimensions
--5-6-e-4- 55'/52
TOTAL SQUARE FOOTAGE
,k8--79--zoct 0
WA State Contractor license # 1
LANZCGD072P5
Main floor area
& /0z1
Unfinished basernent area
X3-6' 1045
Mailing address
815 E. Rosewood Ave.
2nd floor area
0
Finished basement area
0
Architecl/Engineer
Independent Home Designs
Garage area
"7'7—
Size of decks, etc.
120 Oover30"
What ie the heat source?
forepd air gs
What is the coat of your project?
Manufactured Home
Sign
Width:
Length:
What is the square footage of
the sign lace?
How high is the sign?
Year:
Make:
Installer
Contractor
We Stele 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 Slate Contractor license #
WA State Contractor license #
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 State Contractor license #
WA Stale Contractor license #
Mailing address
Mailing address
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities,
NFIR 'OU
S P O K A N E �; , '�- -.:" _ C
UTnSrrES DIVISION
N. Bruce Rawls, P.E. Utilities Director
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
Gary Oberg, Director
GENERAL FACIUTIES CHARGE (GFC)
PAYMENT OPTION SELECTION RECORD
PLEASE NOTE: Form must be filled out accurately and in its entirety, and signed, or a permit will not be issued.
Date: ice'
Plat Name: 1�11�" ,�' !f '`�,: T` Lot No(s): Z- Block No(s): Z
, -i- A,ur"r1DQ,
/
Site Address(es): r. 5714— 13'-t'NS Parcel No(s): 1—%l ,3S4 .,0.5CD
L,grvzcE G - 4� (--C2--e,9--
Owner
--C2----Owner Name: OR Builder Name: -:'ir--
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. ( ) GFC to be paid at closing, at the GFC rate in effect at the time of closing.
3. ( ) GFC payment in 24 equal monthly payments upon establishment of Sewer Billing Account.
Complete ane of the following statements.
a. Owner's Statement: I, , understand that 1 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 1
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 disciose 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 992600180 • (509) 477-3604 FAX: (509) 477-4715 TDD: (509) 324-3166
ADDRESS 'L Ili
ZONE L,L< -3 .5
ROAD WIDTH 35g' -
FRONT 3 j ' FLAN
COMMENTS
REVIEWED
s
Kr0
z 0
O
m
115.97�fo;
(n
(1)
LOT 1
13' WIDE
BORDER
EASEMENT
This site plan is being submitted for thepurpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
Tines/dimensions, curb lines, structures and easements
have been identified. Also indicated are wetlands,
bodies of water, steep slopes or other critical areas.
Signe
J
(75
UJ
J
O
0
RIGHT OF WAY
STA: 16+25
16.5' L
INSTALL TYPE 1
CURB INLET
EL=2036.16
m
U
m
0
0
O
0
Tv,
Z
CO
SCALE: 1 "=30'
RIGHT OF WAY
LOT 2, BLOCK 20
SUMMERFIELD EAST 4th ADD.
J V J1 1 1 L Al _SAIL
ry 1 s r .v _ n
ENGINEERS SURVEYORS
1220 N. HOWARD ST.
SPOKANE. WA 99201
FAX (509) 326-0423
(509) 328-5139
101 TRAIN RD.
LEWISTON. 10 6.3501
FAX (208) 746-6625
(208) 746-2661