2002, 11-07 Permit App: 02009958 ResidenceProject Number: 02009958 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: 7 Right: 7 Rear: 50
Site Information:
Plat Key: 006156 Name: SHELLEY LAKE 3RD ADD PUD
Contact:
Address:
C - S - Z:
Phone:
Group Name:
Project Name:
GEORGE H WHITE INC
PO BOX 52
LIBERTY LAKE, WA 99019
(509) 921-9752
District: F
Parcel Number: 45245.2603 Block: 1
SiteAddress: 843 S SHELLEY LAKE LN
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District:
Area: 14,296 Sq Ft
Urban Residential 3.5
Width: 84
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: ::>...............................................................
Lot: 3
Owner: Name: GEORGE H WHITE INC
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 160 Right Of Way (ft): 30
Review
Site Plan Review
KA -46
Plan Review
Released By.
—PbP e6-frAl-tf:&
Released B'
Approach / Drainage
Flood plain
a,2.1NAt 11
Sewer Review
Released By•
Operator: CKF Printed By: CKF
Print Date:
11/7/2002
Project Number: 02009958
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 Type
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
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: Ell
Critical Materials:
This Application:
Sq Ft Valuation
1,755 $21,586.50
168 $1,315.44
832 $9,984.00
1,755 $115,830.00
Totals: 4,510 $148,715.94
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Mechanical Permit
Stories:
Total Project:
Su Ft Valuation
1,755 $21,586.50
168 $1,315.44
832 $9,984.00
1,755 $115,830.00
4,510 $148,715.94
Fee Amount
$1,140.00
$4.50
$250.80
$1,395.30
Firm: UNKNOWN
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
4 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: CKF Printed By: CKF
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: 02009958 Inv: 1 Application Date: 11/7/2002 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: UNKNOWN
Address: UNKNOWN
UNKNOWN, WA UNKNOWN
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firm: UNKNOWN
Phone: (000) 000-0000
Units
3
6
2
2
1
1
1
1
1
Fee Amount
$1,395.30
$95.00
$108.00
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Invoice Amount
$1,395.30
$95.00
$108.00
$1,598.30 $1,598.30
Fee Amount
$18.00
$36.00
$12.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
Amount Paid
$0.00
$0.00
$0.00
$108.00
Amount Owing
$1,395.30
$95.00
$108.00
$0.00
$1,598.30
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
ll
SPOKE CURVY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: /VE U.7 RP_S I t to IU C`€ CSC
TYPE OF APPLICATION
Building Permit
Ca Relocation
O Change in Use
Street Address:
O Sign
Assessor's Tax Parcel Number(s):
O Grading
O Tenant (New/Change)
O Manufactured Home Permit
O Other
SPECIFIC SITE INFORMATION
S S ktC(e, Lorke. LN rAda-(€ tick 9,637
i, Z a --L . 74,03
Legal Description:
tiO011P4ti
FireDist
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
Right:
0 Owner: Phone:
et/yq-'G Fax:
5 i'n
Cl Applicant:
" Phone:
Fax:
Mailing Address:
Mailing Address:
City, State, Zip
City, State, Zip
Phone
Cl Contractori
51: WI
❑ Architect/Engineer
Phone
Fax
George hteFa nc.
Mailing address
Box 52
Mailing address
State Zp
at State i
Liberty Lace, Wa. 99019
City, State Zip
WA State Contractor license #
cr�errj l,w 1" P8
Contact name:
PROJECT INFORMATION
Building height to peak f
# of stories f
Building Information
Main floor sq. ft. ?„_.
? S�
Unfinished basement sq. ft.
/ 76
Dimensions
5t/,c
s"
Occupancy group
Cost of project
Total habitable space
/7;
Construction ype
2"d floor sq. ft.
Garage sq. ft.� 3
'2—
Finished basement sq. ft.
Deck sq. ft. /
Heat
Heat source (electric, gas, etc)
Co A r t1 { c e. t f'"
ariuMft d
ac ure ome
Width:
Year:
. .
Rilob#10±1'
Length:
sign
What is the square footage of the sign
face?
How high is the sign?
Make:
# of signs
Area of existing signs
Previous address
Fire Safety.
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
4,3/7,ecial Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name Phone
Inspectors:
El Concrete 0 Welding 0 Bolting 0 Reinforcement
Plans Examiner
Phone
Address
Inspector
Phone
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes jag\No
I :yes, identify 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?
jJ2es, identib, on site plan 0 Yes )7;C No
What is the current use of this property?
J A—C- A,e Kr
Isyour property in a designated wildlife habitat area?
0 Don't know 0 Yes No
Will the site be served by a septic system? 0 Yes X No
Is any part of the property within a 100 yr flood plain?
Is
/./yes, 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, identib, on the site plan 0 Yes Y\No
Are there any wetlands, streams or ponds within 200 feet of the
property?
lyes, ide-ntib, on site plan 0 Yes KNo
Is there evidence of fill or excavation on the property?
0 Yes )1K,No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
0 Yes No
Are critical or hazardous materials used or stored on site?
0 Yes No
DEPARTMENT USE ONLY
I1heprppthy in a designated Stormwater0E3Coyyenetrssol Anoreao
0 No
Is, the property inside the ASA? 00 yeYess 0 No
Is, the Property inside the PSSA?
Is public sewer available to the site? 0 Yes 0 No
Is public 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
[_Dae Received:
I
Staff Representative:
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