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2002, 10-29 Permit App: 02009638 ResidenceProject Number: 02009638 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/29/2002 Project Information: Permit Use: RESIDENCE W/GARAGE - GAS Setbacks: Front 32.5 Left: 7 Right: 36 Rear: 35 Site Information: Plat Key: 006306 Name: SUMMERFIELD EAST 4TH ADD Contact: DOUGLASS, LANZCE Address: 8510 N CRESTLINE C - S - Z: SPOKANE, WA 99217 Phone: (509) 483-6532 Group Name: Project Name: District: H Parcel Number: 46354.9050 Block: 17 SiteAddress: 14810 E CROWN RD SPOKANE, WA USA 99216 Location:: SPO Zoning: UR -3.5 Urban Residential 3.5 Water District: 001 TRENTW OOD Area: 13,362 Sq Ft Width: 105 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Lot: 10 Owner: Name: Address: DOUGLASS, LANZCE 8510 N CRESTLINE SPOKANE, WA 99217 Hold: ❑ Depth: 127 Right Of Way (ft): 45 Page 1 of 3 Review Site Plan Review Released Plan Review Released By: "6,12- // �� Z Approach / Drainage Released By: 0 '... e AA, is 0 1 Flood plain o aJSct, its 5 Sewer Review/0 _94,0 Operator: JAS Printed By: JAS Print Date: 10/29/2002 Project Number: 02009638 Inv: 1 Perniits: 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 Finn: LANCZE G DOUGLASS, INC Phone: (509) 483-6532 Building Characteristics Const Category: New Group: Nbr Of Dwellings: Occupant Load: Bldg W x D: s Building Sq Ft: Req Parking: Handicap Parking: Description BASEMENT U DECK GARAGE RESIDENCE Grp R-3 R-3 U-1 R-3 Type Notes VN VN VN VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE Type: Building Height: Stories: Sprinklers: ❑ Critical Materials: ❑ This Application: Total Project: Sq Ft Valuation Sq Ft Valuation 1,148 $14,120.40 1,148 $14,120.40 120 $939.60 120 $939.60 792 $9,504.00 792 $9,504.00 1,148 $75,768.00 1,148 $75,768.00 Totals: 3,208 $100,332.0(1 3,208 $100,332.00 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK 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 Permit Total Fees: Mechanical Permit Units 1 1 3 4 1 1 Operator: JAS Printed By: JAS Fee Amount $900.00 $4.50 $198.00 $1,102.50 Firm: DANCAR MECHANICAL INC. Phone: (509) 924-9921 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: 02009638 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 10/29/2002 Page 3 of 3 Contractor: GOLD SEAL MECHANICAL INC Address: 5524 E BOONE AVE SPOKANE, WA 99212 Item Description TOILETSBIDETS 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 Plumbing Permit Firm: GOLD SEAL MECHANICAL INC Phone: (509) 535-5944 Units 2 3 1 1 1 1 1 3 Unit Desc NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF Permit Total Fees: Fee Amount Invoice Amount $1.102.5() $1.102.5() $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 $1,102.50 $85.00 $78.00 $1,265.50 $1.265.50 $0.00 $1,265.50 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 SHE address? ASSESSOR'S tax parcel number? L\S 1 CD r rowAy Legal description as it appears on the property LOT /0 BLOCK J---2 deed OC,erina-e---Fsev1--f e",4-/ /2 • OWNER or OCCUPANT Phone Lanzce G. Douglass, Inc. 509-483-6532 Mailing address City, state Zip 815 E. Rosewood Ave. Spokane, WA 99208-5507 Who should we contact regarding this project? Phone Lanzce G. Douglass 509-483-6532 What work is being done under this permit? Single Family . Lone : -Inspector district Property size . ight of way width Water district • . . ***SEL ATTACHED ENERGY CALCULATIONS*** Building . . • '. .. .. . . 936 split w/gai. side Building height # of stories 1 Contractor Lanzce G. Douglass. Inc. Dimensions -5-6*24 tfQx 5 TOTAL SQUARE FOOTAGE j.43--9-1,19,, WA State Contractor license # LANZCGD072P5 Main Iloor area -9-3-6- 11 q 3 2nd floor area 00 Unfinished basement area —9-3-6 14S Finished base nent area -gize of decks, etc, 120 Oover30" Mailing address 815 E. Rosewood Ave. Architect/Engineer Independent Home Designs Garage area .48G" 772, whet is the heat source? fnrrpd ijj What is the cost of your project? Manufactured Home . Sign. VVidth: Length: Length: What is the square footage of the sign face? How high is the sign? Year: Make: Installer Contractor We State Contractor license # Wa State Contractor license # Mailing address Mailing address -Relocation 1 , Fire Safety i- * Previous address , Fire Sprinkler Tent Paint booth Fire Alarm Fireworks display VALUE Contractor Contractor WA Stale Contractor license # WA State Contractor license # Mailing address Mailing address Fuel'Storage Tanks Swimming Pool (Circle one) Above -ground Underground Size / gallons Private Contents of tank(s) Size / gallons Public/semi-private Contractor Contractor Wa State Contractor license # WA Slate Contractor license # Mailing address Mailing address Spokane Co.mty does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities. NPL' Ge '0 tr-N l.:YI i S P O K A N E __ ' y, ,; �_tt C O LJ N T Y" UTILrr s DIVISION N. Bruce Rawls, P.E., Utilises Director A DIVISION OF THE PUBLIC WORKS DEPART- ENT Gary Oberg, Director GENERAL FACILITIES CHARGE (GFC) PAYMENT OPTION SELECTION RECORD PLE4SE NOTE: Form must be filled out accurately and in its entirety, and signed, or a permit will not be issued. Date: /6> Plat Name: lid/i'" .:"' _! "� s 7` Lot No(s): ICD Block No(s): 1 -7 vrT1f AD() Site Address(es): Owner Name: 10 ( trO c.Uni PRINT Owner's Name Parcel No(s): 14,?j.5-4 •crOSZ:D -vzcEG.4,�z��S OR Builder 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 dosing. Yom► 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 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 1, 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 1025 W. Broadway • Spokane, WA 99260-0180 • (509) 477-3604 FAX: (509) 477-4715 TDD: (509) 324-3166 RIGHT OF WAY ROAD 28+00 � 2 b 3� •� I �. STA: 28+30 OFFSET: 27.2 R INSTALL TYPE A DRYWELL. RIM=2036.45 0 w 85.47' SWALE N 1= 0 0 0 1n oo LO Oci 0 N 0 0 d 0 CP Engr—Plot \dWg \67930010 0 w E E 0 U) ip 0 Cn RIGHT OF WAY SIDEWALK STA: 17+25 16.5' R INSTALL TYPE 1 CURB INLET EL=2036.66 RIGHT OF WAY BURNS ROAD 0 0 + w J 0 14' WIDE — BORDER EASEMENT This site plan is being submitted for thepurpose o obtairing a building permit and is a true and correc, 13' WIDE representation of the proposal. All known property BORDER Tines/dimensions, curb lines. structures and easementsEASEMENT have been identified. Also indicated are wetlands, bodiep of water, steep slopes or other critical areas. 105.47' 10' WIDE EASEMENT FOR UTILITIES Signed: Date: 10' WIDE %o EASEMENT FOR UTILITIES 0 U 1 1 ` N LOT 9 LOT 11 SCALE: 1 "=30' LOT 10, BLOCK 17 SUMMERFIELD EAST 4th ADD. — . 1 >•� ENGINEERS o SURVEYORS 1220 N. HOWARD ST. WA 99201 FAX (509E) 328-0423 (509) 328-5139 101 THAIN RD. LEW1STON. 1044 0 83501 FAX (208) 746-6825 (206) 746-2861