2002, 11-17 Permit App: 02009968 ResidenceProject Number: 02009968 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/7/2002 Page 1 of 3
Project Information:
................................................................
Permit Use: RESIDENCE W/GARAGE - NATURAL GAS
Setbacks: Front 25 Left: 10 Right: 10 Rear: 40
Site Information:
Plat Key: 006156 Name: SHELLEY LAKE 3RD ADD PUD
Contact: GEORGE H WHITE IN
Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Phone: (509) 921-9752
Group Name:
Project Name:
District: F
Parcel Number: 45245.2601 Block: 1
SiteAddress: 839 S SHELLEY LAKE LN
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District
Area: 10,931 Sq Ft
Urban Residential 3.5
Lot: 1
Owner: Name: GEORGE H WHITE IN
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Width: 80 Depth: 128 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .;.....
Review
Site Plan Review
L-16 — 'Fear ..(kal'ftt-ne.–
Plan Review
Approach / Drainage
Released By: ;
C24
Flood plain
Released By. 11
t31
a. JNA %Di
Sewer Review
r
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Operator: CKF Printed By: CKF
Print Date: 11/7/2002
Project Number: 02009968
Permits:
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/7/2002 Page 2 of 3
Contractor: GEORGE 11 WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New
Nbr Of Dwellings:
Bldg W x D: x
Req Parking:
Description
BASEMENT U
DECK
GARAGE
RESIDENCE
Grp
R-3
R-3
U-1
R-3
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Type
VN
VN
VN
VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Notes
Contractor: UNKNOWN
Address: UNKNOWN
UNKNOWN, WA UNKNOWN
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
Type:
Building Height:
Sprinklers:
Critical Materials:
This Application:
Sq Ft Valuation
1,729 $21,266.70
200 $1,566.00
736 $8,832.00
1,729 $114,114.00
Totals: 4,394 $145,778.70
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Mechanical Permit
Units
1
1
3
4
1
1
1
Operator: CKF Printed By: CKF
Stories:
Total Project:
Sq Ft Valuation
1,729 $21,266.70
200 $1,566.00
736 $8,832.00
1,729 $114,114.00
4,394 $145,778.70
Fee Amount
$1,125.00
$4.50
$247.50
$1,377.00
Firm: UNKNOWN
Phone: (000) 000-0000
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
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
$10.00
$95.00
11/7/2002
Project Number: 02009968 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 11/7/2002 Page 3 of 3
Plumbing Permit
Contractor: UNKNOWN Firm: UNKNOWN
Address: UNKNOWN Phone: (000) 000-0000
UNKNOWN, WA UNKNOWN
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Notes:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Units Unit Desc
3 NUMBER OF
6 NUMBER OF
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount Invoice Amount
$1,377.00
$95.00
$102.00
$1,377.00
$95.00
$102.00
Fee Amount
$18.00
$36.00
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
Amount Paid
$0.00
$0.00
$0.00
$102.00
Amount Owing
$1,377.00
$95.00
$102.00
$1,574.00 $1,574.00 $0.00 $1,574.00
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 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: 11/7/2002
1 1
Aiii
mliken
SPOKE COMA'
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: ive C.2 7 RP -S. I t ru C ---
TYPE OF APPLICATION
C 4-f`
A-11 G k&
)I' Building Permit
O Change in Use
O Grading
0 Manufactured Home Permit
Ll Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address:
63.9 S Ski I�� LA-ke. Lt.J C) (Adak 1449,637
Assessor's Tax Parcel Number(s):
Legal Description:
Water District/Purveyor:
Setbacks
Front:
OWNER/APPLICANT INFORMATION
Indicate who should be contacted regarding this project
1.7_1 Owner: n Phone:
5 4r1#V'- to Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:
Mailing Address:
Dimensions
L/&602-
City, State, Zip
City, State, Zip
Finished basement sq. ft.
DI Contractor Phone
F
C]eorge 5i.
0 Architect/Engineer
Phone
Fax
1' i" / GZte LI i,(..
Mailing address
Boa- 52
Mailing address
Cost of project'`
/ yl, OD,
City, State Zip Liberty Laky , (Wa. 99019
City, State Zip
WA State Contractor license #
gee) rej11 w bel 1 P g
Contact name:
PROJECT INFORMATION
Building Information
Bu ilding height to peak
34'
# of stories
I
Main floor sq. ft.
/ 72-%
Unfinished basement sq. ft.
>- -7z7
Dimensions
L/&602-
Total habitable space
,--)2y
2nd floor sq. ft.
-
Finished basement sq. ft.
Occupancy group
Construction type
w
Garage sq. ft.
Ceq.
Deck s-23
Cost of project'`
/ yl, OD,
Heat source (electric, gas, etc.)
CO A 5- t-Ut-c e t1 a. C-.
4.•
Mantifactured Hoirte
sign•
!Width:
-.: Year:
•
Length:
What is the square footage of the sign
face?
How high is the sign?
Make:
# af signs
Area of existing signs
Previous address
Fire safety.
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
, Proposed use
Value
' r --
4."peciai i. 1 T
.)rispections Required?
Firm Name Phone
Non -Residential Energy Code Compliance.
Plans Examiner
Phone
Inspectors:
Address
Inspector
Phone
15 Concrete 0 Welding 0 Bolting 0 Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes \No
I yes, identih on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
identih on site plan 0 Yes )7t No
What is the current use of this property?
V A -r-- Ik- Kr
_11Yes,
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes X...No
Will the site be served by a septic system? CI Yes >t(No
I(s any part of the property within a 100 yr flood plain?
Ihes, identih on site plan
,
0 Maybe 0 Don't know 0 Yes X No
Are or will there be wells located on the property?
Ifyes, identih on the site plan 0 Yes Y,\No
Are there any wetlands, streams or ponds within 200 feet of the
property?
"yes, identih on site plan 0 Yes KNo
Is there evidence of fill or excavation on the property?
0 Yes X,No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
,,---". %) 0 Yes V No
Are critical or hazardous materials used or stored on site?
0 Yes IIK.No
DEPARTMENT USE ONLY
Is the ProPenY in a designated Stormwater Control Area?
Yes 0 No
/14 the property inside the ASA? 0171 yeYes
00 N�: Is the property inside the PSSA? Yes
Is public sewer available to the site? 0 Yes 0 No
Is pub ic.water available to the. site? 0 Yes 0 No
Is the property located within 1000 feet of a Natural Resource
Area? 0 Yes 0 No
Date Received:
I
Staff Representative:
t atf
82.53
APPROXIMATE LOC TION
OF ADOPTED ' 100
FLOOD PLAIN LIMI AT
CATION CONT
2027.0 N.G. V.O. .••••
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•
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�97 TO C1/4
N$' 4'20'W
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1
51922 "I LA'
9
root' woo'
57'
11
This site plan is being submitted for the purpose Of
obtainings i;ui,d ng permit and is a true and correct
representation of the proposal. Alt known property
lines/dimensions, curb lines, structures and easements
have been identified. Also indicated are wetlands,
bodies of water, steep slopes or other critical areas.
Signed:
Date:
ADDRESS 5/
ZONE
ROAD WIDTH
FRONT
COMMENTS
REVIEWED
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