2001, 06-08 Permit App: 01004470 ResidenceProject Number: 01004470 Inv: 1
Application
Date: 6/8/2001 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
..................................... .
Permit Use: NEW RESIDENCE W/GARAGE - F A GAS
Setbacks: Front 25 Left: 10 Right: 5 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:
Parcel Number: 45245.9000 Block: 3
SiteAddress: 852 S SHELLEY LAKE LN
GREENACRES, WA USA 99016
Location:: GRE
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 11,081 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot: 4
Owner: Name:
Address:
GEORGE H WHITE INC
PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 30
Department
BUILDING
Hold Reasons:
Permit Conditions:
BUILDING
Hold Reasons:
Permit Conditions:
ENGINEER
Hold Reasons:
Permit Conditions:
BUILD I G
easons:
it Conditions:
UTILITIES
Permits:
Reasons:
Permrt Conditions:
Review
Site Plan Review
Plan Review
Releas•
ed By:. f
Approach / Drainage
Released R'
Special Reviews
1/000..kg,
Released By:
e -6de-64
f /4_)
Sewer Review Released By: Lt (1(1 ill WI. OWL ki
Q.V.) Ctilaa/-'-H71fet � 4 &*vOSl(tf
9
atf a
to
s e ).9
Project Number: 01004470
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/8/2001 Page 2 of 3
Contractor: GEORGE 11 WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category:
Nbr Of Dwellings:
Bldg W x D: 49
Req Parking:
Description
2ND FLOOR
BASEMENT U
DECK
GARAGE
RESIDENCE
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 255-9204
New Group: R-3
1 Occupant Load:
x 50 Building Sq Ft:
Handicap Parking:
Gtr Type Notes
R-3 VN
R-3 VN
R-3 VN
U-1 VN
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
GAS WATER HEATER
GAS APPLIANCE >100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
Type: VN
Building Height: 28 Stories: 2
3491 Sprinklers: 0
Critical Materials: ❑
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
982 $60,884.00 982 $60,884.00
1,315 $15,201.40 1,315 $15,201.40
180 $1,324.80 180 $1,324.80
660 $7,920.00 660 $7,920.00
1,194 $74,028.00 1,194 $74,028.00
Totals: 4,331 $159,358.20 4,331 $159,358.20
Units
Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Fee Amount
$1,195.00
$4.50
$262.90
Permit Total Fees: $1,462.40
Mechanical Permit
Units
1
1
4
5
1
1
1
1
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 255-9204
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$10.00
$15.00
$4.00
$50.00
$10.00
$10.00
$10.00
$10.00
$119.00
Project Number: 01004470 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 6/8/2001 Page 3 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Payment Summary::::::;;;::
Operator: MKC
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Notes:
Plumbing Permit
Units
4
7
1
3
1
1
1
1
2
Printed By: MKC
Fee Amount Invoice Amount
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 255-9204
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Amount Paid
$0.00
$0.00
$0.00
$1,462.40
$119.00
$126.00
$1,462.40
$119.00
$126.00
$1,707.40
$1,707.40
Fee Amount
$24.00
$42.00
$6.00
$18.00
$6.00
$6.00
$6.00
$6.00
$12.00
$126.00
6/8/2001
Amount Owing
$1,462.40
$119.00
$126.00
$0.00 $1,707.40
SPOKE COUNTY
1A1
Project Description:
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
CI - it`f 9 /
r l Fz a c s (—
TYPE
TYPE OF APPLICATION
1 Clee 5,4r
'A Building Permit
❑ Change in Use
0 Grading
0 Manufactured Home Permit
0 Relocation
0 Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: P5'2.-..Sk,e, ((e.( L 0, Le_ L W "e-- Ue i 0 i) C Le W A
Assessor's Tax Parcel Number(s): 990
3 7
Legal Description: L D 7 4
J �� Ya 0 0 C T 1 0 4U S li e I /c"y 4.-
!� -
Department,Use Only :.
City, State, Zip
Finished basement sq. ft.
Water District/Purveyor:
Sewer District/Purveyor
Phone
Fax
Road width
Setbacks
Front: Rear:
Left: Right:
Cost of project
School District:
Fire District:
Zoning
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
0 Owner: Phone:
Fax:Fax:
0 Applicant:
Phone:
Mailing Address:
Mailing Address:
Dimensions ,
City, State, Zip
City, State, Zip
Finished basement sq. ft.
Contactor Phone
Fax
❑ Architect/Engineer
Phone
Fax
y� �.
Mailing address George H `iNhite, Die.
Mailing address
Cost of project
City, State Zip rr IBRy 52
% `t'Ua. 9901.9
City, State Zip
WA Stare Contraca L� La ,
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
2 6 '
# of stories
Z
Main floor sq. ft.
//�5/
Unfinished basement sq. ft.
/3/s
Dimensions ,
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
Construction type
Garage sq. ft.
Deck sq. ft. ,_
Cost of project
Heat source (electric, gas, etc)
Manus:tuted Home
Width:
Length:
Sign
What is the square footage of the sign
face?
How high is the sign?
Year:
Make:
# of signs
Area of existing signs
Previous address
Fire Safety
Fire Sprinkler
Paint booth Fire Alarm
Tent
Fireworks display
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
What is the current use of this property?
s L o 7_
Phone
Will the site be served by a septic system? O Yes 15k' No
Plans Examiner
Phone
Inspectors:
Is there evidence of fill or excavation on the property?
O Yes tc'No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /oh) 0 Yes Al/ No
Are critical or hazardous materials used or stored on site?
O Yes )k3'No
Address
Inspector
Phone
O Concrete
O Welding
El Bolting
O Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? 0 Yes A No
If yes, identify on site plan
What is the current property size? ) 1 0 & 1 S
(square feet or acres)
Is any part of the property within 250 feet of a shoreline?
jf yes, identify on site plan 0 Yes X No
What is the current use of this property?
s L o 7_
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes ,t No
Will the site be served by a septic system? O Yes 15k' No
Is any part of the property within a 100 yr flood plain?
If yes, identify on site plan
0 Maybe 0 Don't know Yes O No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes gr 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?
O Yes tc'No
Are there slopes greater than 30% on the property? (30 ft rise in 100 ft)
( /oh) 0 Yes Al/ No
Are critical or hazardous materials used or stored on site?
O Yes )k3'No
DEPARTMENT USE ONLY
Is the property in a designated Stormwater Control Area?
OYes Q No
Is public sewer available to the site? O Yes O No
Is the property inside the ASA?
O Yes
O Yes
O No
O No
Is public water available to the site? O Yes O No
Is the property inside the PSSA?
O Yes
0 No
Is the property located within 1000 feet of a Natural Resource
Area? O Yes 0 No
Date Received:
Staff Representative:
iSite plan is being submitted for the pule** _
Ming a building permlt and \s s tnts nnd Wee=
tesentabon of the propos,-; f\': -ronertV
diMensions, curb lines. sr._,._ ., --;rnents
been idenitfied• Also \sc'.,c,,,...e..:, :, - ,. ,, -..
' 01 Water, steep slopes or ot'r,k.::,,
t:ts:
6-2 7
f.
(0 ,
85 2 “
/ 7
•
)`titi i)WL
/L -"Uv
1)6?'
0
ADDF,:,zos
ZO N E
,_T
D
COF\47,,ONT-6
Rtz,v,) — F
"
c/7
171/( ) - • - '0/7