1999, 11-09 Permit App: 99010856 ResidenceProject Number: 99010856 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/09/19 Page 1 of 3
Project Information:
t. y =Wa -
Permit Use: RESIDENCE W/GARAGE - NATURAL GAS Contact: GEORGE H WHITE INC
Address: PO BOX 52
C - S - Z LIBERTY LAKE, WA 99109
Phone: (509) 994-2928
Site Information: IMLISOMNAMIWOMINWAIMPANN,nWNW. zgoa
District: F
Setbacks: Front 20 Left: 5 Right: 5 Rear: 40
Plat Key: 005977 Name: SHELLEY LAKE SECOND ADDITb(
Parcel Number: 45242.2304
SiteAddress: 817 S SHELLEY LAKE LN
VERADALE, WA USA 9903
Location:: VER
Zoning: UR -3.5
Water District:
Area: 10,011 Sq Ft Width: 88
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Urban Residential 3.5
Owner: Name: GEORGE H WHITE INC
Address: PO BOX 52
LIBERTY LAKE, WA 99109
Hold: ❑
Depth: 140 Right Of Way (ft): 30
Department Review
BUILDING Site Plan Review
Comments:
BUILDING
r
(1_, ICot Zto
j) -q9
Plan Review
UTILITIES
Permits:
Co
Approach / Drainage
-fJ�a--- 1/ 5'F
—1q V IVA1(,6
614) r i- to -RN
Sewer Review
mments: O1C.'CO 15SL BUILDli\X.?EE.1-(If1�I QNLY-
D 3 u -t CAN Ni err (aE c 'D u l s E¢ L1 lue.s ARE Acc ErTCD.
ViREMIMMOMNEMEKt
Cn To issu v -5 ci\-P
Cl-io —��
Project Number: 99010856 Inv: 1
U J
'Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/09/19 Page 2 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 255-9204
Const Category: New
Nbr Of Dwellings: 1 Occupant Load:
Bldg W x D: 54 x 54 Building Sq Ft:
Req Parking: Handicap Parking:
Description Grp Type Notes
BASEMENT U R-3 VN
GARAGE U-1 VN
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: S & R HEATING
Address: UNKNOWN
UNKNOWN
Item Description
GAS WATER HEATER
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS .
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
UNLISTED GAS >400,000BTU
HOOD -TYPE II
Building Height: 19 Stories: 1
3760 Sprinklers:
Critical Materials: ❑
This Application: Total Project:
SQ Ft Valuation Su Ft Valuation
1,880 $21,732.80 1,880 $21,732.80
500 $6,000.00 500 $6,000.00
1,880 $116,560.00 1,880 $116,560.00
Totals: 4,260 $144,292.80 4,260 $144,292.80
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,120.00
$4.50
$246.40
$1,370.90
Firm: S & R HEATING, INC
Phone: (509) 990-1351
Units Unit Desc
1 NUMBER OF
5 # OF UNITS
1 NUMBER OF
4 NUMBER OF
.1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$10.00
$5.00
$12.00
$40.00
$10.00
$10.00
$10.00
$100.00
$10.00
$207.00
Project Number: 99010856 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/09/19 Page 3 of 3
Contractor: BURT PLUMBING SERVICE
Address: 23904 E RIVER RD
OTIS ORCHARDS, WA 99027
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Payment Summary:
Operator: CKF
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Notes:
Plumbing Permit
Units
3
4
1
1
1
1
1
1
3
Printed By: CKF
Fee Amount
$1,370.90
$207.00
$96.00
Firm: BURT PLUMBING SERVICE
Phone: (509) 226-0542
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$18.00
$24.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
$96.00
Print Date: 11/09/1999
Invoice Amount
$1,370.90
$207.00
$96.00
$1,673.90
$1,673.90
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$1,370.90
$207.00
$96.00
$0.00 $1,673.90
4139
_11
dr L1L'IAT)(
/0-(
•
•
This site ;.Ian `Jeing submitted for the. p'.rpose of
'fling a building permit and is a true and correct
•••••■„ representation of the proposal. Ali known property
linesldimensiAs, curb lines, structures aneasements
have been identified. Al • icated are u d
bo. ie • - .- . slo es o ritical areas.
Signed:
Date
ger