2003, 03-31 Permit App: 03002120 ResidencePtolect Number: 03002120 Inv: 1 Application Date 3/31/2003
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use RESIDENCE W/GARAGE -NATURAL GAS
Setbacks. Front 25 Left: 13 Right: 8 Rear: 32
Site Information:
Plat Key:
Page 1 of 3
Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 15620 E SECRETARIAT
C - S - Z: VERADALE, WA 99037
Phone: (509) 999-7733
Group Name:
Project Name:
Name: SHELLEY LAKE 02ND ADD PUD
District: F
Parcel Number: 45243.2401
Block: 3 Lot: 1
SiteAddress: 829 S GALWAY LN
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5
Water District.
Urban Residential 3.5
Area: 9.374 Sq Ft Width: 75
Nbr of Bldgs: 1 Nbr of Dwellings: l
Review btformation:
Owner: Name: CLIFF SCHMITZ CONSTRUCTION
Address: 15620 E SECRETARIAT
VERADALE, WA 99037
Hold: ❑
Depth: 125 Right Of Way (ft): 30
Review
Site Plan Review
Released Bv: La-%—�x� 3 f Wit •03
Plan Review
Released By: i6 5710-1-4-:"
Sewer Review 'Z 1 tri
Permits:
Released By:
Operator: CKF Printed By: CKF
Print Date: 3/31/2003
Project Number: 03002120
Inv. 1
•
Application
Date: 3/31/2003 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: CLIFF SCHMITZ CONSTRUCTION Firm: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT
VERADALE WA 99037
Building Characteristics
Total Area
Building Height 20
Stories
3584
Description Grp Type
BASEMENT U R-3 VN
GARAGE U-1 VN
RESIDENCE R-3 VN
Item Description
STATE SURCHARGE
RESIDENTIAL SURCHARGE
RESIDENTIAL VALUATION
Phone:
Notes
(509) 922-4297
This Application:
Sq Ft Valuation
1,792 $22,041.60
616 $7,392.00
1,792 $118,272 00
Totals: 4,200 $147,705.60
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Contractor: BLUE FLAME HEATING & A/C
Address. 6011 E 9TH
SPOKANE, WA 99212
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
1100D -TYPE II
Total Project:
Sq Ft Valuation
1,792 $22,041.60
616 $7,392.00
1,792 $118,272.00
4,200 $147,705.60
Fee Amount
$4.50
$249.70
$1,135.00
Permit Total Fees: 51,389.20
Mechanical Permit
Firm: BLUE FLAME HEATING & A/C
Phone. (509) 536-0186
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: CKF Printed By: CKF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$3.00
$30.00
$10.00
$10.00
$10.00
$85.00
3/31/2003
Project Number: 03002120 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date. 3/31/2003
Contractor: JIMMY'S PLUMBING
Address: 1702 S MAMER
SPOKANE, WA 99216
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
"PUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Notes:
Payment Swumary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Page 3 of 3
Firm: JIMMY'S PLUMBING
Phone: (509) 928-8991
Units Unit Desc
2 NUMBER OF
4 NUMBER OF
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$1200
$24 00
$6.00
$12.00
$ 6.00
$6.00
$6.00
$6 00
$18.00
$96.00
Fee Amount
$1,389.20
$85.00
$96.00
Invoice Amount
$1,389.20
$85.00
$96.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owm°
$1,389.20
$85.00
$96.00
$1,570.20 $1,570.20
$0.00
$1,570.20
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: CKF Printed By: CKF Print Date: 3/31/2003
I�I
A10E1SPOKN C,�LINTY
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
'1026 \VEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
W'1
(SLK
5' feL(&j I90 StetivtX
Project Description:
er<uilding Permit
RCsiDtn E.
5x 12� q'37`-{ 310
O Change in Use
❑ Grading
O Manufactured Home Permit
0 Relocation
O Sign
O Tenant(New/Change)
O Other
°De artment_Use:.°...YI`r -
P
0 Applicant:
Phone
Fay
-
i er.;,..... —
»s;:,
Water District/Purveyor.' . -.
• Sewer District/Puireyoi
_
:
y}-;
^ ., .
. Road width
-•.�.t >�: •
• Setbacks .
. Front - -
-_
Left - _
Rear
-R.ghe. —
School District .
.. 't
...lire District,
.v __-
\\'A State Contactor license #
C,CA.EPSC/v 1/
- -
-Zoning
OWNER/APPLICANT INFORMATION
0 fnAin to So Junk/ be 'whoa/rcpr,,,bnp /lu, pnprd
0 Owner Phone:
Fu:
0 Applicant:
Phone
Fay
Mailing Address
Mailing Address:
Dimensions•
6)% K62
City, State, Zip
City, State, Zip
Ivutshcd basement sq ft.
-5—
taetnr Phone 141-- 7733'...
(:,qnli LIPC SGiirn cr. eopsra r; i -LT N'7 1
0 Architect/Engineer
Ph one
Fa.
Mailing address
it SZ -O 6, S E Cert 4-ociNe..T
Mailing address
(f/
1 lent source (chane, tins, etc.)
City, State Zip
LYRA-0MP- I") r 9 cl. 6
Cnl State Zip
\\'A State Contactor license #
C,CA.EPSC/v 1/
Contact name:
PRO IECT INFORMATION
.. • Building Information
Building hei'ht to cak
F
# of stories
Alain floor sq. ft.
1792
Unfinished basement sq. ft.
(74-7
Dimensions•
6)% K62
'fund habits le space
3 S g z/
P'^ dour ss. n.
f3-
Ivutshcd basement sq ft.
-5—
Occupancy group
(nstruction type
Garage sq. ft.
1
Deck sq. ft.
Cost of project
(f/
1 lent source (chane, tins, etc.)
iwarytutat-tLL1l.0 11VIIIC
Width:
Length:
What is the square Menge of the sip,
face?
I low high is the .sign?
Yrtr:
Alake:
# of signs
Ana of existing signs
Fireworks display
Is there evidence of fill or excavation on the property?
❑ Yes No /
Are there slopes greater than 30% on the property? (30ft se in 100 ft)
( /Wu) 0 Yes 0.No
Proposed use
Relocation
FireSafety;•`
Firm Name
Previous address
Phone
Fire Sprinkler _
'Tent
Paint booth _ Fuc Alarm
Fireworks display
Is there evidence of fill or excavation on the property?
❑ Yes No /
Are there slopes greater than 30% on the property? (30ft se in 100 ft)
( /Wu) 0 Yes 0.No
Proposed use
Value
Special InspectionsiRequire.d?` ; ' .`:" ;:
Non=ResidentialEneigy Code Compliance?'
Firm Name
What is the current use of this property? p
Phone
Plan, l=mmmtr
Phone
In.peoors-
Is there evidence of fill or excavation on the property?
❑ Yes No /
Are there slopes greater than 30% on the property? (30ft se in 100 ft)
( /Wu) 0 Yes 0.No
Are critical or hazardous materials used or sroved 00 site" ye
0 lyes / No
Address
Inspector
Phone
0 Concrete
O Welding
O Bolting
0 Reinforcement
Address
DITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes ly No
If yes. identify on site plan
What is the current property sire n/j
(square feet or acres) -r 31 S
Is any part of the property rvithin 250 feet of a shore e?
If yrs. ident�' on the plan 0 Yes No
What is the current use of this property? p
15 your property in a designated wildlife habitat area? J/
0 Don't know 0 Yes O No
— J/
Will the site be served by a septic system? 0 Yesf1YNft
any part of the property within a 100 yr flood plain?
lbw, idenlly on site plan
0 Maybe 0 Don't know 0 \'cs No
Arc or will there be wells located on the property?
Ilya, iden ifi on the site plan 0 YesIs
No
Are there any wetlands. streams or ponds within 2r0�0�e of the property?
If yes, Ident on s to pia ❑ Yes IHtNo
Is there evidence of fill or excavation on the property?
❑ Yes No /
Are there slopes greater than 30% on the property? (30ft se in 100 ft)
( /Wu) 0 Yes 0.No
Are critical or hazardous materials used or sroved 00 site" ye
0 lyes / No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Arca?.
', .. 0. Ycs - 0 -No
Is public sewer available to the sire? 0 Yes 0 Nn
.. ..
Is the property inside the ASA? . -
. , ..
.. 0 'Yes' 0- No .
O Y6.',0 No .
Is public water available to the site? , O Yes 0 No
t - _
Is the property inside the PSSA? -
.
0 Yes 0 No
Is the propert•,located within 1000 feet of a Natural Resource Arca? -
0 Yes 0 No
Uau Itcten4J.
Staff Repm.encunc
METHOD OF PAYMENT
VISA
®
0 CASIl 0 CIIIiCI: 0 0
._ . '
DIICOVER
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D.\'I'li:
EXPIRES:
H.\NKC-\RD NU\IHFIt
.\LrI'I TORI%IUD SIGNATURE:
SUBTOTAI,
TOTAL FEE
MINIMUM PERM?FEE IS $AW PLEASE
SIAKECHECKS PAYAIOEIDSPOIUNE
COC7 IY PPt'Irr CCVIWI
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&cob'?" CliPi-b
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5
37:11 GALS f I tib,
This site plan is being submitted far the purpose of
obtaining a building permit and is a true and correct
representation of the proposal, All known property
linesfdimensions, curb line:. structures and easements
have been identifi .. • .' di.:ted are tlands,
bodies of w,a} r, s •. • • lop `i. o 1 athe��r as.
•Signed: . rL_L A.��
Date. II, - 1 �,�
ADDRESS -5, S2 c-1- 67D-1vJai L'1
ZONE LAD, 3,,e) --
ROAD
,.tipROAD W1IDT1, c3e, 30
FRONT 2.5 FLANKING 3F>
COMMENTS
REVIEWED BY G4'`LC4.24aJ