2002, 05-09 Permit App: 02003535 CarportProject Number: 02003535 0: 1
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Application
• Date: 5/9/2002 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
.........................................................................................................................................
Permit Use: 18 X 80 CARPORT Contact: GEORGE H. WHITE INC
Address: BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Setbacks: Front Left: Right: Rear: Phone: (509) 255-5000
Group Name: 04-17-9 CSC(
Site Information:
Project Name:
.....................................................................................................................................................................................................
Plat Key: 000104 Name: ASSESSOR'S PLAT#6
District:
F
Parcel Number: 45103.1101 Block:
SiteAddress: 12704 E NORA AVE
SPOKANE, WA 99206
Location:: SPO
Zoning: UR -22
Water District:
Urban Residential -22
Lot:
Owner: Name: NORA WEST LLC
Address: 12704 E NORA AVE
SPOKANE, WA 99216
Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review Coordinator
Plan Review
Site Drainage Review
�a / C
Landuse Review
Permits:
Operator: RMB Printed By: RMB
Print Date: 5/9/2002
Project Number: 02003535
Inv:� � Application Date: 5/9/2002
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52 Phone: (509) 921-9752
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New Group: S-2 Type: HN
Nbr Of Dwellings: 0 Occupant Load: 0 Building Height: 8 Stories: 1
Bldg W x D: 18 x 80 Building Sq Ft: 1440 Sprinklers: ❑
Req Parking: 0 Handicap Parking: 0 Critical Materials: El
This Application:
Description Grp Type Notes Sq Ft Valuation
CARPORT S-3 VN 1,440 $13,795.20
Building Permit
Firm: GEORGE HARVARD WHITE CON
Item Description
COMMERCIAL VALUATION
PLAN REVIEW FEE
COMMERCIAL SURCHARGE
STATE SURCHARGE
Payment Summary:
Permit Type
Building Permit
Totals: 1,440 $13,795.20
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Total Project:
Sq Ft Valuation
1,440 $13,795.20
1,440 $13,795.20
Fee Amount
$213.00
$138.45
$77.32
$4.50
$433.27
Fee Amount Invoice Amount Amount Paid Amount Owing
$433.27 $433.27 $0.00 $433.27
$433.27 $433.27
$0.00 $433.27
Page 2 of 2
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: 5/9/2002
l 1
iti
SPOKE COUNTY
Project Description:
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
TYPE OF APPLICATION
Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
O Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: 7a (,,1 41- s NOR
% f
_SPO, LJ
Assessor's Tax Parcel Number(s): z7/ 5-/ U / / (� /
Legal Description:
Road
Setbadks?-
Front
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
0 Owner: Phone:6-6/—"'41/00
MOP itx. �` Lc,- c Fx: 7,6-63/ L/
0 Applicant:
11IO 14
7.. Phone:
kie-s Fax:
J
Mailing Address:Mailing
) 2 70y 1 e., I"
Address:
Ct St t
(�►
City, State, Zip
arContractor Phone 2 1_ 9 7 5
t 7 4e Cfi A ./' J i z ! t 5 1 (.f2 9i9,1— 97
(
0 Architect/Engineer
Phone
Fax
Mailing address
pGX S Z, LiQ.�', Um,, 9'OP,,
Mailing address
City, State Zip
City, State Zip
WA State Contractor license #
Contact name:
Build hgight to peak
�6 sionse,
PROJECT INFORMATION
Building Information
# of stories
C�}
Aer0 f •
Total habitable space
Main floor sq. ft.
2"d floor sq. ft.
yku
Unfinished basement sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft.
Cost of project
6
Heat source (electric, gas, etc.)
r 05/16/2002 08:13 5095349755
s%% NORTHWEST
2214 East Riverside
Spokane, WA 99202
(509) 534-9711
(509) 534-9755 • Fax
DATE:
May 16, 2002
TO:
Jun
COMPANY:
STI NORTHWEST r1-4ut ni
FAX TRANSMITTAL
PAGES:
3
INCLUDING COVER SHEET
FAX:
477-4703
Spokane County Building Department
FROM:
Alan K. Bain
PROJECT
NOTES;
Jun:
PHONE:
J033:
George White Inc. Carport project #02003535
Here is the Special Inspector and Testing Lab Acknowledge Forms for the above referenced
project.
Alan
Confidentiality Notice
This document(s) accompanying this fax transmission contain(s) information, which is confidential and privileged. This information is intended to be for
the Individual or entity set forth above. if you are not the intended recipient, please be aware that any disclosure, copying, distribution or use of the
contents of this information is prohibited. Thank you.
J:\stifextorm -vi.0-4/00
i 05/16/2002 08:13 5095349755
STI NORTHWEST
SPECIAL INSPECTOR AND TESTING LAB
EMPLOYMENT ACKNOWLEGEMENT FORM
Please complete one form for each INDIVIDUAL performing Special Inspection or Testing work on each
project.
Date May 16, 2002
Project Address 12704 East Nora
Project Name
inspection or Lab Firm Name STi Northwest
Project No. 02003535
Address 2214 East Riverside Avenue; Spokane, Washington 99202
Phone (509) 534-9711
Name of individual performing work Harry Groanvelt
ICl3O Number 5048188-85
Supervisor (if Trainee) _
(must be Certified inspector)
STATEMENT OF UNDERSTANDING
1, Harry Groar.zelt , hereby affirm that I have been
employed by STI Northwest for a duration of the proiect
(hours, days, weeks) to provide special inspections under Section 306 of the Uniform Building Code of:
Structural Steel Boltin and Weld.in
( ] Non -Certified Trainee
ICBO No
as it relates to the above stated project and that I am aware that as special inspector, my duties and
responsibilities include: 1) Observation of the work assigned for conformance with the approved design
drawings and specifications, 2) Furnishing inspection reports to the building official, and the engineer or
architect of record, in addition to other designated persons. All discrepancies shall be brought to the
immediate attention of the contractor for correction, them, if uncorrected, to the proper design authority and
to the building official, and 3) Submitting a final signed report stating whether the work requiring special
inspection was, to the best of my knowledge, in conformance with the approved plans and specifications
and the applicable workmanship provisions of the Uniform Building Code.
T also agrec to immediately notify the building official if my employment as it relates to this project is
modified in any way or terminated prior to submittal of my final report.
Individual's Signature IZULlL- j
Supervising Special Inspector's Signature
(required if individual is a Trainee)
05116/2002 08:13 5095349755
STI NORTHWEST PAGE 11:3
p STRUCTURAL MASONRY - During preparation of masonry wall prisms. sampling and placing of all
masoruy units, placement of reinforcement, inspection of grout space, immediately prior to closing of
cleanouts, and during all grouting operations.
0 REINFORCED GYPSUM CONCRETE - When cast -in-place Class B gypsum concrete is being mixed and
placed.
n INSULATING CONCRETE FILL - During the application of insulating concrete fill when used as part of a
structural system_
O
SPRAY -APPLIED FIREPROOFING - As required by Uniform Building Code Standard No. 7-6.
O PILING, DRILLED PIERS AND CAISSONS - During driving and testing of piles and construction of cast -
in -place drilled piles or caissons_
• SHOTCREIE - During the taking of test speciment and placing of all shotcrete and as required by Section
1922.10 dt 1922.11 Uniform Building Code,
• SPECIAL GRADING, EXCAVATION AND FILLING - During earthwork excavations, grading and filling
operations inspection.
• SPECIAL CASES - Work which, in thc opinion of the Building Official, involves unusual hazards or
conditions_
2. The owner hereby certifies litat the special inspector(s) named in this agreement have been
engaged to perform tests and inspections, as indicated in the checklist above, during
construction to satisfy all applicable portions of the Uniform Building Code.
PART 4. DESIGNATION OF SPECIAL INSPECTOR(S)
List special inspector(s) intended to be employed by thc owner, include name, address and phone
number for all individuals who will be doing on-site or lab work relating to the required tests and
inspections.
Alan K. B
in
Phone 15091 465-15
111 •
• • •
Harry Grganvelt P.O.. ,B x H; $anripnf nt TT) R186
Phone (208) 263-0885
10