2003, 04-02 Permit App: 03002213 ResidenceProject Number: 03002213 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/2/2003 Page 1 of 3
Proiect Information:
....................
Permit Use: RESIDENCE/ATTACHED GARAGE - FORCED
AIR GAS
Setbacks: Front 100 Left: 20 Right: 75 Rear: 35
Site Information:
Plat Key: Name:
Contact: GEORGE H. WHITE INC
Address: BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Phone: (509) 255-5000
Group Name:
Project Name:
District: F
Parcel Number: 45245.2608
Block: 1
SiteAddress: 853 S SHELLEY LAKE LN
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5
Water District:
Area: 33,812 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:::;..................................................................
Lot: 8
Owner: Name: GEORGE H WHITE
Address: BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 30
..............
Review
Site Plan Review
erre- per
Plan Review
Approach / Drainage
Sewer Review
Permits:
Released By d
FM1-4
Released By:
Operator: RMB Printed By: RMB
Print Date: 4/2/2003
Project Number: 03002213
Inv: 1
Application
Date: 4/2/2003 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: GEORGE 11 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: Type:
Occupant Load: Building Height: Stories:
Building Sq Ft: Sprinklers: El
Handicap Parking: Critical Materials:
This Application: Total Project:
Su Ft Valuation Su Ft Valuation
1,636 $20,122.80 1,636 $20,122.80
140 $1,096.20 140 $1,096.20
748 $8,976.00 748 $8,976.00
1,655 $109,230.00 1,655 $109,230.00
Description Type Notes
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
Contractor: GEORGE 11 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
Totals: 4,179 $139,425.00 4,179 $139,425.00
Units Unit Desc
1 Y OR BLANK
1 Y OR BLANK
1 Y OR BLANK
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,095.00
$4.50
$240.90
$1,340.40
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
5 # OF UNITS
5 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: RMB Printed By: RMB
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$5.00
$50.00
$10.00
$10.00
$10.00
$107.00
4/2/2003
Project Number: 03002213 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/2/2003 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
CROSS CONNECTION DEVICES
WATER USING DEVICES
Payment Summary
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Units
3
6
2
1
1
1
1
1
1
1
Fee Amount
$1,340.40
$107.00
$108.00
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:
Invoice Amount
$1,340.40
$107.00
$108.00
$1,555.40 $1,555.40
Fee Amount
$18.00
$36.0(1
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
Amount Paid
$0.00
$0.00
$0.00
$108.00
Amount Owing
$1,340.40
$107.00
$108.00
$0.00
$1,555.40
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: RMB Printed By: RMB Print Date: 4/2/2003
I l
1111
SPo COUNTY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description: RP_S A1 C -�L—
TYPE OF APPLICATION
r c) 3 C_441A-11- G.q&
P‹ Building Permit
O Change in Use
O Grading
O Manufactured Home Permit
O Relocation
O Sign
O Tenant (New/Change)
O Other
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel
Legal Description:
�-- -- s S In t "Oct LK) ��,Ck 4 CSA- c e G)4 9,e37
Number(s):52,(4 5 • � :rc/b
Serbacks -.ice
Fire District:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
Left
Right: ,s
0 Owner: Phone:
n �
4eVII `- e, Fax:
0 Applicant:
Phone:
c
207 CJ t�p : v Ak
Mailing Address:
Mailing Address:
City, State, Zip
City, State, Zip
0 Contractor !�f (/ q Phonee/y/�.
iteFalnc•
0 Architect/Engineer
Phone
Fax
George J L. {4
Mailing address u
Box 52
Mailing address
City, State Zip
L�derty Lakse, `l�%a. 99019
City, State Zip
WA State Contractor license #
Contact name:
PROJECT INFORMATION
Building height to peak
Dimensions
# of stories
Total habitable space
Building Inforrriation
Main floor sq. ft.
/r'as J
2°d floor sq. ft.
Unfinished basement sq. ft.
/G 3c
Finished basement sq. ft.
Occupancy group
Construction typ
Garage sq. ft. 71/
6
Deck sq. ft. f
Cost of project
Heat source (electric, gas, etc.)
c1�
I
29
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represe 'att�an of the pro,�o;Ql. All kna�t�n property � �� �..J +� ' •
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Inca ,s
/dim ons, curb lines�.�w.o...
, structures and easements
have been identified. Also indicated are wetlands,
bodies of Water, steep slopes of other critical areas.
SiQned:
Date:
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