2003, 03-20 Permit App: 036001808 ResidenceProject Number: 03001808 Inv: 1
,Application
Date: 3/20/2003 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 25 Left: 6 Right: 6 Rear: 30
Site Information:
.........................
........................
Plat Key: Name:
Contact: GEORGE H WHITE, INC
Address: BOX 52
C - S - Z: LIBERTY LAKE WA 99019
Phone: (509) 921-9752
Group Name:
Project Name:
District: F
Parcel Number: 45245.2707 Block: 3
SiteAddress: 842 S SHELLEY LAKE LN
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 9,634 Sq Ft
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Width: 70
Review Information:
ot: 7
Owner: Name: GEORGE H WHITE, INC
Address: BOX 52
LIBERTY LAKE WA 99019
Hold: ❑
Depth: 126 Right Of Way (ft): 30
Review
Site Plan Review
Released<
Plan Review
•Released By. .
Approach / Drainage
Sewer Review
Permits:
Operator: JAS Printed By: JAS
Released By: E'i \ 5
Print Date: 3/20/2003
3O3
Project Number: 03001808 Inv: 1
Application ,
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Date: 3/20/2003 Page 2 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Const Category: New Group:
Nbr Of Dwellings: Occupant Load:
Bldg W x D: x Building Sq Ft:
Req Parking: Handicap Parking:
Description Type Notes
BASEMENT U R-3 VN
GARAGE U-1 VN
RESIDENCE R-3 VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Item Description
DUCT SYSTEMS
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
Type:
Building Height: Stories:
Sprinklers: ❑
Critical Materials: El
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,757 $21,611.10 1,757 $21,611.10
768 $9,216.00 768 $9,216.00
1,757 $115,962.00 1,757 $115,962.00
Totals: 4,282 $146,789.10 4,282 $146,789.10
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Fee Amount
$1,130.00
$4.50
$248.60
Permit Total Fees: $1,383.10
Mechanical Permit
Units
1
1
1
3
1
3
1
1
1
Operator: JAS Printed By: JAS
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$10.00
$12.00
$3.00
$12.00
$30.00
$10.00
$10.00
$10.00
$107.00
3/20/2003
Project Number: 03001808 Inv: 1
•
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/20/2003
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
CROSS CONNECTION DEVICES
WATER USING DEVICES
Notes:
Payment Summary::::<.
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Units
2
5
1
2
1
1
1
1
1
3
Page 3 of 3
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount Invoice Amount
$1,383.10 $1,383.10
$107.00 $107.00
$108.00 $108.00
$1,598.10 $1,598.10
Fee Amount
$12.00
$30.00
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$108.00
Amount Owing
$1,383.10
$107.00
$108.00
$0.00
$1,598.10
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fords 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: JAS Printed By: JAS
Print Date: 3/20/2003
I 1
Aink
SPOKE COUNTY
PROJECT APPLICATION °"' r V,
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCI N
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: AJ (.() RP_S G (u C cc) 3 c /4-r A-11-- GA --i
TYPE OF APPLICATION
XBuilding Permit
0 Change in Use
0 Grading
0 Manufactured Home Permit
0 Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: 1- S S (h t ( (t4 L A- ke, L N ie r A d a- f e k)4 9,-637
SjD
Assessor's Tax Parcel Number(s): � �--
Legal Description:
L0-7
31th
Water Disirict/Ptirveyor:
School District:
Sewer District/Ptirveyor.,"
Fire District:
oad Width
Zoning
Setbacks
Front
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
0 Owner: Phone:
'G Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:
Mailing Address:
Dimensions
5 Z x 51_3.---/
City, State, Zip
City, State, Zip
Finished basement sq. ft.
0 Contractor f (� Phone
!j]y/�.
C eO%�E 4)hiteFalnc.
0 Architect/Engineer
Phone
Fax
J L.
Mailing address
'BcX 52
Mailing address
of project i Q v
/3
City, State Zip Liberty Lake., 'Wa. 99019
City, State Zip
WA State Contractor license #
G € c rG t.. ,.,i t1 7' / P R
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
'
# of storiesMain
(
floor sq. ft.
/7. 7
Unfinished basement sq. ft.
/7S7
Dimensions
5 Z x 51_3.---/
Total habitable space
2"d floor sq. ft.
---
Finished basement sq. ft.
Occupancy grouper
Construcuott ype
�/
Garage sq. ft. -76'Y
I:1. t sq. ft./ 6
HI,Cost
of project i Q v
/3
Heat source (electric,gas, etc.)
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ADDRESS
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ROAD wDln F
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Signed:
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