2002, 05-07 Permit App: 02003434 ResidenceProject Number: 02003434 Inv: 1
' --Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/7/02 Page 1 of 4
Proiect Information:
pF . ,t o :: , .. 4.s sm,,
Permit Use: RESIDENCE W/GARAGE - GAS Contact: GEORGE H WHITE INC
Setbacks: Front 25 Left: 15 Right: 70 Rear: 60
Site Information:
Plat Key: 006156 Name: SHELLEY LAKE 3RD ADDITION
Address: BOX 52
C - S - Z: LIBERTY LAKE WA 99019
Phone: (509) 991-0429
Group Name:
Project Name:
District:
F
Parcel Number: 45241.2607 Block: 1 Lot: 7
SiteAddress: 851 S SHELLEY LAKE LN
GREENACRES, WA USA 9901
Location:: GRE
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 26,138 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Owner: Name: GEORGE H WHITE INC
Address: BOX 52
LIBERTY LAKE WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 20
Review Information: 0., , mwe r x�rc
Review
Site Plan Review
Plan Review
Releasedy
'""`•
Released By:
Critical Area Review
Shoreline Review
Released By
Approach / Drainage
Rebased
Released By:
prki v r 1 P 33
Operator: JAS Printed By: JAS
Print Date: 5/7/02
617 OP. -
Project Number: 02003434
Inv: 1
Application
Date: 5/7/02 Page 2 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Flood plain
Sewer Review
Permits:
F & -2
Released
y.
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Group: R-3 Type: VN
Const Category: New
Nbr Of Dwellings:
Bldg W x D: 54 x
Req Parking:
Description
BASEMENT F
DECK
GARAGE
RESIDENCE
•
Buil ' ing Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
1 Occupant Load:
52 Building Sq Ft:
Handicap Parking:
Grp
R-3
R-3
U-1
R-3
'km Notes
VN
VN
VN
VN
Item Description
RESIDENTIAL VALUATION
STATE SURCHARGE
RESIDENTIAL SURCHARGE
Operator: JAS
Building Height: 14
3490 Sprinklers: El
Critical Materials:
This Application:
So Ft Valuation
1,745 $29,246.20
160 $1,252.80
576 $6,912.00
1,745 $115,170.00
Totals: 4,226 $152,581.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Printed By: JAS
Permit Total Fees:
Print Date:
Stories: 1
Total Project:
Sq Ft Valuation
1,745 $29,246.20
160 $1,252.80
576 $6,912.00
1,745 $115,170.00
4,226 $152,581.00
Fee Amount
$1,160.00
$4.50
$255.20
$1,419.70
5/7/02
Project Number: 02003434 Inv: 1
—Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/7/02 Page 3 of 4
Contractor: S & R HEATING
Address: 15501 N YALE RD
MEAD, WA 99021
Item Description
DUCT SYSTEMS
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
AIR CONDITIONER:4-15 TONS
VENTILATING FANS
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
Contractor: BURT PLUMBING SERVICE
Address: 23904 E RIVER RD
OTIS ORCHARDS, WA 99027
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER SOFTENER
WATER USING DEVICES
Mechanical Permit
Firm: S & R HEATING, INC
Phone: (509) 467-3960
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
4 # OF UNITS
1 NUMBER OF
6 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Fee Amount
$10.00
$10.00
$12.00
$4.00
$20.00
$60.00
$10.00
$10.00
$10.00
$10.00
Permit Total Fees: $156.00
Plumbing Permit
Firm: BURT PLUMBING SERVICE
Phone: (509) 226-0542
Units Unit Desc
3 NUMBER OF
6 NUMBER OF
2 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Operator: JAS Printed By: JAS
Permit Total Fees:
Fee Amount
$18.00
$36.00
$12.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$12.00
$120.00
Print Date: 5/7/02
Project Number: 02003434 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/7/02 Page 4 of 4
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$1,419.70 $1,419.70
$156.00 $156.00
$120.00 $120.00
$0.00 $1,419.70
$0.00 $156.00
$0.00 $120.00
$1,695.70 $1,695.70
$0.00 $1,695.70
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 other state or local laws or ordinances.
Signature:
Operator: JAS Printed By: JAS
Print Date: 5/7/02
( l
ii
SPOKE COUNTY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: R e S' (d e, e-tC. (A)/ 3 C t#- r I cCo ft — Fo« c d 4t r G A S
TYPE OF APPLICATION
*Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
SPECIFIC SITE INFORMATION
Street Address:
061 h e( e `I L�Ic. L A -r' 'e
❑ Applicant:
' I '
Assessor's Tax Parcel Number(s): 4..JI . '-'1•4
Mailing Address:
Legal Description:
Lol. —)r 'Floc. k 1
3 t �.
�1
C� d. c� , `" tti-e-N
City, State, Zip
Department Use Only
❑ Contractor Phone
axl/
❑ Architect/Engineer
Phone
Fax
Water District/Purveyor:
Sewer District/Purveyor
J2--
r52
City, State Zip
Liberty, Lake, Wa. 99019
Road width
Setbacks
Front:
Left:
Rear:
Right:
School District:
Fire District:
Occupancy group
Zoning
OWNER/APPLICANT INFORMATION
Er Indicate who should be contacted regarding this project
❑ Owner: Phone:
SiS't+yf,/L ( Fax:
❑ Applicant:
Phone:
S 6-1,1A(.._ Fax:
Mailing Address:
Mailing Address:
Building het ht to peak
/ i
City, State, Zip
City, State, Zip
# of stories
I
❑ Contractor Phone
axl/
❑ Architect/Engineer
Phone
Fax
Mailing address George �f. White lJy/�.
µ
Ba
Mailingaddress
J2--
r52
City, State Zip
Liberty, Lake, Wa. 99019
City, State Zip
2nd floor sq. ft.
---
WA State Contractor license #
Contact name:
Finished basement >, ,., ft.
i 7y1
PROJECT INFORMATION
Building Information
Building het ht to peak
/ i
# of stories
I
Main floor sq. ft.
)7 444.
Unfinished basement sq. ft.
Dimensjans
51( X
J2--
Total habitable space
7,�. c J
2nd floor sq. ft.
---
Finished basement >, ,., ft.
i 7y1
Occupancy group
Construction type /
V
Garage sq. ft. . 76
Deck sq. ft. w
Cost of project / +/j
/ /
/s��
l/
Heat source (electric,rgas, etc.)
C�G' t -i c' ti`i
't'v
'. wE., r� ,.
Manufactured Home 1Sign
Fire Safety
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?
P L^ 1 — (Z2L c_71-
Previous address
Will the site be served by a septic system? O Yes A,No
Paint booth
Fire Sprinkler
Tent
_
Fire Alarm
Fireworks display
Are critical or hazardous materials used or stored o site?
O Yes No
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
P L^ 1 — (Z2L c_71-
Phone
Will the site be served by a septic system? O Yes A,No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?,
O Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) O Yes $ No
Are critical or hazardous materials used or stored o site?
O Yes No
Address
Inspector
Phone
O Concrete
O Welding
O Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? O Yes X' No
If yes, identify on site plan
What is the current property size?.--, ; '
(square feet or acres) a e
Is any part of the property within 250 feet of a shorel' e?
If yes, identify on site plan O Yes A No
What is the current use of this property?
P L^ 1 — (Z2L c_71-
Is your property in a designated wildlife habitat area?
O Don't know O Yes krNo
Will the site be served by a septic system? O Yes A,No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
O Maybe O Don't know O Yes No
Are or will there be wells located on the property?
If yes, identify on the site plan O Yes /it,No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan O Yes 'No
Is there evidence of fill or excavation on the property?,
O Yes No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( / %) O Yes $ No
Are critical or hazardous materials used or stored o site?
O Yes No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
O Yes O No
Is public sewer available to the site? O Yes 0 No
Is the property inside the ASA?
O Yes
O Yes
O No.
0 No
Is public water available to the site? O Yes 0 No
Is the property inside the PSSA?
O Yes '
O No
Is the property located within 1000 feet of a Natural Resource
Area? O Yes O No
Date Received:
Staff Representative:
Ur SETBACK
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Th. . plan is being submitted , of
obtaini g a building permit an e a rict
• represepliVion of the pro .i All known p o erty
. lines/ditelions, nes. structures and easements
have b en id ed. w , ,Aln cated are wetlands,
other critical areas.
6#1P;Y:liv 717
Sinned:
Date:
ADDRESS lk 5/
*ZONE
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APPOKIMATt =AWN oF
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