2002, 02-28 Permit App: 02001152 ResidenceProject Number: 02001152 Inv: I AY% ilOII Date: 2/26/2002 Page 1 of 3
THIS IS_ NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
Parcel Number: 45224.4406 Block: 5 Lot: 6
SiteAddress: 1429 S DAVIS LN Owner: Name: BRISBANE, DONALD N & MARIA
SPOKANE, WA USA 00000 Address: 22809 E COUNTRY VISTA DR APT
Location:: SPO LIBERTY LAKE, WA 99019
Zoning: UR -7 Urban Residential -7
Water District: Hold: ❑
Area: 6,351 Sq Ft Width: 59 Depth: 130 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
ReviP���
Site
Permits:
Operator: RMB Printed By: RMB Print Date: 2/26/2002
Project Number: 02001152 Inv: 1 Applicatidn Date: 2/26/2002 Page 2 of 3
Contractor
Address:
THIS IS NOT A -PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
MIKE PEPLINSKI Firm: MIKE PEPLINSKI
PO BOX 178 Phone: (509) 226 -3963
NEWMAN LAKE, WA 99025
3,582 $115,283.76
Units
Unit Desc
Building Characteristics
Const Category:
New
Group: R -3 Type: VN
Nbr Of Dwellings:
1
Occupant Load:
0 Building Height: 19
Bldg W x D: 39
x 37
Building Sq Ft:
2948 Sprinklers: ❑
Req Parking:
0 Handicap Parking:
0 Critical Materials: El
NUMBER OF
$10.00
This Application:
Description
Gtr
Type Notes
Sa Ft Valuation
BASEMENT U
R -3
VN
1,474 $17,039.44
DECK
R -3
VN
162 $1,192.32
GARAGE
U -1
VN
472 $5,664.00
RESIDENCE
R -3
VN
1,474 $91,388.00
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: MIKE PEPLINSKI
Address: PO BOX 178
NEWMAN LAKE, WA 99025
Item Description
GAS WATER HEATER
GAS APPLIANCE <= 100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0 -3 TONS
VENTILATING FANS
GAS LOG OR GAS INSERT
Totals:
3,582 $115,283.76
Units
Unit Desc
1
Y OR BLANK
1
Y OR BLANK
1
Y OR BLANK
Permit Total Fees:
Mechanical Permit
Stories: 1
Total Project:
So Ft
Valuation
1,474
$17,039.44
162
$1,192.32
472
$5,664.00
1,474
$91,388.00
3,582 $115,283.76
Fee Amount
$975.00
$4.50
$214.50
$1,194.00
Firm: MIKE PEPLINSKI
Phone: (509) 226 -3963
Units
Unit Desc
Fee Amount
1
NUMBER OF
$10.00
1
NUMBER OF
$12.00
3
# OF UNITS
$3.00
1
NUMBER OF
$12.00
5
NUMBER OF
$50.00
1
NUMBER OF
$10.00
Permit Total Fees:
$97.00
Operator: RMB Printed By: RMB Print Date: 2/26/2002
Project Number: 02001152 Inv: 1 A Cat —ion Date: 2/26/2002 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: S T PLUMBING CO INC Firm: S T PLUMBING CO INC
Address: P.O. BOX 1817 Phone: (509) 244 -5575
AIRWAY HEIGHTS, WA 99011
Item Description
Units
Unit Desc
Fee Amount
TOILETSBIDETS
3
NUMBER OF
$18.00
SINKS
6
NUMBER OF
$36.00
SHOWERS
1
NUMBER OF
$6.00
TUBS
2
NUMBER OF
$12.00
DISH WASHERS
1
NUMBER OF
$6.00
CLOTHES WASHER
1
NUMBER OF
$6.00
FLOOR DRAINS
1
NUMBER OF
$6.00
CROSS CONNECTION DEVICES
1
NUMBER OF
$6.00
WATER PIPING - DWV
1
NUMBER OF
$6.00
WATER USING DEVICES
3
NUMBER OF
$18.00
Permit Total Fees:
$120.00
Notes
OK TO ISSUE SEWER PERMITS FOR BLOCK I - LOTS 1 TH 10, BLOCK 2 - LOTS 1 TH 12 PER
ROGER 10/23/98
DO NOT ISSUE SEWER PERMITS FOR BLOCK 3 - LOTS 1 TH 7, BLOCK 4 - LOTS 1 TH 5,
BLOCK 5 - LOTS 1 TH 6
Payment Summa
Permit TM e
Fee Amount
Invoice Amount
Amount Paid
Amount Owing
Building Permit
$1,194.00
$1,194.00
$0.00
$1,194.00
Mechanical Permit
$97.00
$97.00
$0.00
$97.00
Plumbing Permit
$120.00
$120.00
$0.00
$120.00
$1,411.00
$1,411.00
$0.00
$1,411.00
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 contrued 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: RMB Printed By: RMB Print Date: 2/26/2002
< < PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509- 477 -3675
SPECIFIC SITE INFORMATION
Street Address: ` '/.? y 5
Assessor's Tax Parcel Number(s): LA 6,
Legal Description:
Project Description: 1)5,4 --°
1W Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit
❑ Relocation ❑ Sign ❑ Tenant (New /Change) ❑ Other
Department Use Only
Water District /Purveyor-
Sewer District /Purveyor
Road width
Setbacks � f
Front /%U Rear:
t -1, \ Fas:
Mailing Address:
O\
e.-.
School District:
Fire District:
Zoning
Contrauor
Phone 2 —i -to 31) 6,3 P)-%
Phone ,/S�
❑ Architect /Fngmcer
Left Right:
OWNER /APPLICANT INFORMATION
0 lnd -1, whn chnubl hr mn[at[rd renlrrlim, Ihic hrnied
(Tenet:
Phone
IApplicant Phone
S2.\
G Pas:
t -1, \ Fas:
Mailing Address:
Mailing Address:
Cm, Sta(e, /ip
CitY, State,'' /,ip
Contrauor
Phone 2 —i -to 31) 6,3 P)-%
Phone ,/S�
❑ Architect /Fngmcer
3 4 x 3 -7
Fax .7 �`�
h
) '' ' jl� � Y.� � _L .. � I:as
6
flailing address
( ka Panes group
Mailing address
P. a
Deck sq. ft.
S IAL:. rcAsr. t ,J
Cite, SState /.ip
41 7 Z
City, State Gip
lV9-
Z
I Ieat source (efcuric, gas, etc.)
\\A State Contractor license �
Contact name:
� k _ IL—
ca
PROiRCT INFORMATION
Building Information
Building height to Ptak
# of stories
Nfain floor sq. ft.
Unfinished basement sq. ft.
Dinxnsions
I otal habitable space
2111 Floor sq. ft.
Finished baSCRlent sq. ft.
3 4 x 3 -7
( ka Panes group
Gmstruction type
Garage sq. ft.
Deck sq. ft.
S IAL:. rcAsr. t ,J
v rC t
41 7 Z
1 fv 2 r
Cost of project
I Ieat source (efcuric, gas, etc.)
(-
Manufactured Home
Si
Width:
Length:
What is thP_square footage of the sign
face
I tow high is the sign?
Year.
Makc: ,.
# of sites
Area of existing signs
❑ Don't know ❑ Yes 3jrNo
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
RelocatiQ!! —
Fire Safety
Previous address
Fire Sprinkler Tent
Paint booth _ " \larm Fireworks display _
Proposed use
Value
Special Inspections Required?
Non - Residential Energy Code Compliance?
Firm Name Phone
Plans Esaminer Phone
Inspectors:
Address
I fyes, identi , on sile lan 173 > . Yes No
Inspector Phone
❑ Concrete ❑ Welding ❑ Bolting ❑ Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? ❑ Yes No
AX,hat is the current property size? S9 A 1J�.
I f yes, identify on site plan
(square feet or acres) (o 3 a
Is any part of the property within 250 feet of a shoreline?
\x hat is the current use of this property?
I fyes, identi , on sile lan 173 > . Yes No
A L kisl V—
Is your property in a designated wildlife habitat area?
\Vill the site be served by a septic system? ❑ Yes .1� No
❑ Don't know ❑ Yes 3jrNo
Is any part of the property within a 100 yr flood plain?
Are or will there be wells located on the property?
If yes, tdenlift on site plan
Ifyes, ideutib, on the .rite plan ❑ Yes J�r No
❑ Alavbe ❑ Don't know ❑ Yes No
❑ Yes ❑ No
Are there any wetlands, streams or ponds within 200 feet of the property?
Is there evidence of fill or excavation on the property?
I f yes, identi ft on site plan 13 Yes No
❑ Yes .5?"'No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
Are critical or hazardous materials used or stored on site?
�% ❑ Yes No
❑ Yes eNo
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
Is public sewer available to the site? ❑ Yes ❑ No
❑ Yes
❑ No
Is the property inside the ASA? ❑ Yes
❑ No
Is public water available to the site? ❑ Yes ❑ No
❑ Yes
❑ No
Is the property inside the PSSA? ❑ Yes
❑ No
Is the property located within 1000 feet of a Natural Resource Area?
❑ Yes ❑ No
Date Received: Staff RepresentatiN-c:
METHOD OF PAYMENT
VISA
❑ C:vSI I ❑ CI n -.Ch ❑ ❑ z ❑
FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD
D.A71(:
B ANKCARD NUNIIII;R:
\U f1 l(AZI %FI) SIGNATURI {:
SUBTOTAL
TOTAL FEE
MINIMUM PERMIT FEE IS $35.WPLEASE
9L\KP: CI IECKS Pk) ABLE 10 SPOKANE
COUNTY PI ::1011'r CHN'l ER