2001, 10-11 Permit App: 01008985 ResidenceProject Number: . 01008985 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/11/01 Page 1 of 3
Project Information:
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 25 Left: 6 Right: 6 Rear: 40
Site Information:
Plat Key: 006156 Name: SHELLEY LAKE 3RD ADDITION
Contact: GEORGE H WHITE INC
Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Phone: (509) 921-9752
Group Name:
Project Name:
District:
G
Parcel Number: 45245.9000
Block: 3
SiteAddress: 846 S SHELLEY LAKE LN
GREENACRES, WA USA 9901
Location:: GRE
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 12,983 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot: 4
Owner: Name: GEORGE H WHITE INC
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 30
Review Information:
Review
Site Plan Review
Plan Review
Approach / Drainage
Sewer Review
Permits:
Operator: JAS Printed By: JAS Print Date: 10/11/01
Project Number: 01008985 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/11/01 Page 2 of 3
Building Permit
Contractor: GEORGE H WHITE CONST Firm: GEORGE HARVARD WHITE CON
Address: 0 BOX 52 Phone: (509) 921-9752
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New Group: R-3 Type: VN
Nbr Of Dwellings: 1 Occupant Load: Building Height: 19 Stories: 1
Bldg W x D: 70 x 54 Building Sq Ft: 2216 Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: ❑
This Application: Total Project:
Description Gra Type Notes Sa Ft Valuation SQ Ft Valuation
2ND FLOOR R-3 VN 288 $17,856.00 288 $17,856.00
COV DECK R-3 VN 130 $1,229.80 130 $1,229.80
GARAGE U-1 VN 704 $8,448.00 704 $8,448.00
RESIDENCE R-3 VN 1,928 $119,536.00 1,928 $119,536.00
Totals: 3,050 $147,069.80 3,050 $147,069.80
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $1,135.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $249.70
Permit Total Fees:
Mechanical Permit
$1,389.20
Contractor: S & R HEATING Firm: S & R HEATING, INC
Address: 15501 N YALE RD Phone: (509) 467-3960
MEAD, WA 99021
Item Description Units Unit Desc Fee Amount
DUCT SYSTEMS 1 NUMBER OF $10.00
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE >100,000BTU 1 NUMBER OF $15.00
GAS PIPING 4 # OF UNITS $4.00
AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00
VENTILATING FANS 6 NUMBER OF $60.00
CLOTHES DRYER 1 NUMBER OF $10.00
RANGE 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD -TYPE II 1 NUMBER OF $10.00
Operator: JAS Printed By: JAS
Permit Total Fees: $159.00
Print Date: 10/11/01
Project Number: 01008985 Inv: 1
application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/11/01
Contractor: BURT PLUMBING SERVICE
Address: 23904 E RIVER RD
OTIS ORCHARDS, WA 99027
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Notes:
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Units
3
6
1
2
1
1
1
1
4
Page 3 of 3
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
$36.00
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$24.00
$120.00
Fee Amount Invoice Amount
$1,389.19 $1,389.19
$159.00 $159.00
$120.00 $120.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$1,389.19
$159.00
$120.00
$1,668.19 $1,668.19 $0.00 $1,668.19
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 contrued to be a permit for, or an approval of, any violation of any of the
provisions of the code or of any o state or local laws or ordinances.
Signature:
Operator: JAS Printed By: JAS
Print Date: 10/11/01
I 1
r1111iiik
SPOKANE COIJKIY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: 1 a W r u rt s(r t,t.e't C 14 r 4- Tr At i er 5 A r
TYPE OF APPLICATION
Building Permit
O Change in Use
El Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
SPECIFIC SITE INFORMATION
Street Address:
@'/ ((e ( Lv\- Le LA ti Ue, )la Le WA
Assessor's Tax Parcel Number(s):
9 9D 3 7
Legal Description:
LOT -5 , (3L0<_3 S>^eLLc
Lk 3 r end
S e //e,y t,a,ke
De artnrmte`
P.:
1
Water Districi/Purveyor
School District:
Sewer District/Purveyor
Road width
Zoning
OWNER/APPLICANT INFORMATION
Q Indicate who should be contacted regarding this project
Setbacks
Front:
Left:
Rear:
Right:
❑ Owner: Phone:
Fax:
❑ Applicant:
Q, �,,� Phone:
t Fax:
Mailing Address:
Mailing Address:
Dimensions
70 f >s S' `l '
City, State, Zip
City, State, Zip
Finished basement sq. ft.
-r —_
ContractorPhone
Fax
El Architect/Engineer
Phone
Fax
Mailing address George SL White, 1ne.
Mailing address
Cost of project
% / 0
City, State Zip [[��� `` //fBryy 52
Wa-. 990/9Contact
City, State Zip
WA State Contract.a64shWy�/ c,
name:
PROJECT INFORMATION
Building Information
Building height to peak
i Cy '
# of stories
1 W i LU + T.
Main floor sq. ft. , Ltv -Cr"
/ �2 1ee3
Unfinished basement sq. ft.
�—
Dimensions
70 f >s S' `l '
Total habitable space
2 / c..e
2"d floor sq. ft.
Finished basement sq. ft.
-r —_
Occupancy group „/C/3
Construction type
1r���J/
Garage sq. ft.
Deck sq. ft�
Cost of project
% / 0
Heat source/('/ellectric, gas, etc.)
Manufactured Home
Sign
Width:
Length:
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Relocation
Fire Safety
Firm Name
What is the current use of this property?
Previous address
Will the site be served by a septic system? 0 Yes ,$( No
Paint booth
Fire Sprinkler
Tent
_
Fire Alarm
Fireworks display
Are critical or hazardous materials used or stored on site?
0 Yes ):i'No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
Phone
Will the site be served by a septic system? 0 Yes ,$( No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
0 Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /%) 0 Yes XNo
Are critical or hazardous materials used or stored on site?
0 Yes ):i'No
Address
Inspector
Phone
0 Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes No
If yes, identify on site plan
What is the current property size?
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
If yes, ident 6 on site plan O Yes I No
What is the current use of this property?
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes ,K No
Will the site be served by a septic system? 0 Yes ,$( No
Is any part of the property within a 100 yr flood plain?
Ifyes, identify on site plan
0 Maybe 0 Don't know X Yes 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes 121 No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan 0 Yes g No
Is there evidence of fill or excavation on the property?
0 Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /%) 0 Yes XNo
Are critical or hazardous materials used or stored on site?
0 Yes ):i'No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? El Yes 0 No
Is the property inside the ASA?
0 Yes
El Yes
0 No
El No
Is public water available to the site? O Yes Cl No
Is the property inside the PSSA?
0 Yes
0 No
Is the property located within 1000 feet of a Natural Resource
Area? 0 Yes O No
Date Received:
Staff Representative:
7/oy
ADDRESS
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COMMENTS
REVIEWED BYc—
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