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2002, 11-07 Permit App: 02009963 ResidenceProject Number: 02009963 Inv: 1 Application THIS ISNOT 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 Contact: GEORGE H WHITE INC Address: PO BOX 52 C - S - Z: LIBERTY LAKE, WA 99019 Phone: (509) 921-9752 Group Name: Site Information: Project Name: .................................................................... . Plat Key: 006156 Name: SHELLEY LAKE 3RD ADD PUD Setbacks: Front 25 Left: 10 Right: 10 Rear: 50 District: F Parcel Number: 45245.2602 Block: 1 Lot: 2 SiteAddress: 841 S SHELLEY LAKE LN SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Urban Residential 3.5 Owner: Name: GEORGE H WHITE INC Address: PO BOX 52 LIBERTY LAKE, WA 99019 Hold: ❑ Area: 11,922 Sq Ft Width: 80 Depth: 141 Right Of Way (ft): 30 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review . .......................... Site Plan Review , i f Released By /rIn fbr arlat(-6Z.' Plan Review Released By: Approach / Drainage Flood plain Released By: .. Sewer Review bit } -q Released By: Operator: CKF Printed By: CKF Print Date: 11/7/2002 Project Number: 02009963 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 H 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: Building Permit Firm: GEORGE HARVARD WHITE CON Phone: (509) 921-9752 Group: Occupant Load: Building Sq Ft: Handicap Parking: Description Grp Type Notes BASEMENT U R-3 VN DECK R-3 VN GARAGE U-1 VN RESIDENCE R-3 VN Item Description RESIDENTIAL VALUATION STATE SURCHARGE RESIDENTIAL SURCHARGE 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: 0 Critical Materials: E 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: 02009963 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 Finn: UNKNOWN Address: UNKNOWN Phone: (000) 000-0000 UNKNOWN, WA UNKNOWN Item Description TOILETS/BIDETS SINKS SHOWERS TUBS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER FLOOR DRAINS WATER PIPING - DWV Permit Type Building Permit Mechanical Permit Plumbing Permit Units Unit Desc 3 NUMBER OF 6 NUMBER OF 2 NUMBER OF 1 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 $12.00 $6.00 $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 tal 111 SPOKANE CouNifY PROJECT APPLICATION SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 WEST BROADWAY AVENUE SPOKANE, WA 99260 509-477-3675 Project Description: L -t 3 RP_s / a a. iv C..-e--- TYPE e--TYPE OF APPLICATION jib Building Permit O Change in Use O Grading O Manufactured Home Permit ("i Relocation O Sign O Tenant (New/Change) O Other SPECIFIC SITE INFORMATION Street Address: eq( s kc L ti Ck4 dA-( e W4 9' 7 Assessor's Tax Parcel Number(s): Legal Description: L`2 - Lk 1 r d. 4 Water•Distncr"%, Purveyor: School District Fire District:. OWNER/APPLICANT INFORMATION El Indicate who should be contacted regarding this project El Owner: Phone: 5 (� 'j -NV'- e.... Fax: IIApplicant: Phone: Fax: Mailing Address: Mailing Address: City, State, Zip City, State, Zip Main floor sq. ft. / )27 fll Contractor r-�/ ,{./! i� r PPhoneC%y/�. FaL/W. geo e ❑ Architect/Engineer Phone Fax y/ J L. I4�hLtt� Mailing address U J Box 52 Mailing address Total habitable space l 71,5 City, State Zip Liberty La%e, `itis. 99019 City, State Zip Finished basement sq. ft. 'A State Contractor license N cjedr.� law °'.ail c.' es Contact name: PROJECT INFORMATION Building Information Buildingheight to peak 3G' # of stories / Main floor sq. ft. / )27 Unfinished basement sq. ft. /727 Dimensions e )C , 2- Total habitable space l 71,5 2nd floor sq. ft. Finished basement sq. ft. Occupancy o Construction,typez //� Garage sq. ft. / 3 Cgaass,tetc.) Deck sq. ft. 2 00 Cost of project 1 /� 1 t 5' 6 ©, Heat source (electric, E ,,, /4 -; ` a`,, i c e r ,N, Jam' :arluf acturE Width: Length: What is the square footage of the sign face? Year: Make: # of signs How high is the sign? Area of existing signs ()cat' _.. Previous address Fire Safety Fire Sprinkler Paint booth Fire Alarm _ Tent Fireworks display Proposed use Value :nst ec loris=Re Firm Name es dential Ernergy Code Compliance?; Plans Examiner Phone Inspectors: Address Inspector Phone 13 Concrete O Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION A're there structures on the property? 0 Yes Pr\No lbws, identify on site plan Isl any part of the property within 250 feet of a shoreline? _hies, identify on site plan 0 Yes No Is' your property in a designated wildlife habitat area? 0 Don't know 0 Yes X_No Is" any part of the property within a 100 yr flood plain? If dies, identify on site plan 1 0 Maybe 0 Don't know 0 Yes X No Are there any wetlands, streams or ponds within 200 feet of the property? !hies, identify on site plan 0 Yes )(No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) %) 0 Yes SKr No What is the current property size? (square feet or acres) What is the current use of this property? �%firx-14 %NT Will the site be served by a septic system? 0 Yes › No Are or will there be wells located on the property? If yes, identify on the site plan 0 Yes \No Is there evidence of fill or excavation on the property? 0 Yes X.,No Are critical or hazardous materials used or stored on site? 0 Yes S(,No DEPARTMENT USE ONLY e;property in adesignated Stormwater Control Area? CI Yes. the property inside the:;ASA?""' the"property inside Is public sewer available to the site? 0 Yes CI No Is public°water.available to the site? Is the'"property located Area? D Yes ONo' ithin 1000 feet of a Natural Resource O' Yes O" No Dane Received: Staff Representative: 4F1 ( ft 49 r4) 4.7ti 922 SF co rhThis Site p':- obtaining a Fi 2:1z correct (J reprep 14trre =stkrS41; A; rem. Ines/dArnensirv,1$ Lnes s7rLi1,r,s arid casements have beg+, ititerv,r1,:ed 4 s ,nri,car.cri Aoctialds, bodies of wrot,r, •i ott-e!ctca! areas. Signed: Date: ADDRESS Si 941 Late_ ZONE LtA 3/5 ROAD '0, iDTH • FRONT 25 FL ANION C; COMMENTS REVIVWF1" / I A. „12rreee Rf/ sAiezt A/fir 47-12 004, 92/-175'2 e