2001, 06-08 Permit App: 01004463 ResidenceProject Number: 01004463 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: 6 Rear: 30
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: Ce It - ete(y'Zq ).$
Project Name:
District:
F
Parcel Number: 45245.9000 Block: 3
SiteAddress: 854 S SHELLEY LAKE LN
GREENACRES, WA USA 99016
Location:: GRE
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 9,590 Sq Ft
Lot: 3
Owner: Name: GEORGE H WHITE INC
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Width: 70 Depth: 113 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: :>:......... .
Department
BUILDING
Hold Reasons:
Permit Conditions:
Review
Site Plan Review
BUILDING Plan Review
Hold Reasons:
Permit Conditions (j1Q.��,/k6-Q,-1-
ENGINEER Approach / Yrainage
Hold Reasons:
Permit Conditions:
BUILD
easons:
t Conditions:
UTILITIES
Permit Conditions:
Permits:
Special Reviews
(11)4'
Qhs
Sewer Review Released By
JQ,oCpn&d 4LJL(�ILIYelhsttift 011
ftY CMOS
Project Number: 01004463
Inv: 1
Application
Date: 6/8/2001 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New Group: R-3
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 255-9204
Nbr Of Dwellings:
Bldg W x D: 50
Req Parking:
Description
2ND FLOOR
BASEMENT U
DECK
GARAGE
RESIDENCE
1 Occupant Load:
x 52 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: 27 Stories: 2
3734 Sprinklers: 11
Critical Materials:
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,213 $75,206.00 1,213 $75,206.00
1,315 $15,201.40 1,315 $15,201.40
180 $1,324.80 180 $1,324.80
694 $8,328.00 694 $8,328.00
1,206 $74,772.00 1,206 $74,772.00
Totals: 4,608 $174,832.20 4,608 $174,832.20
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Permit Total Fees:
Mechanical Permit
Units
1
1
4
5
1
1
1
1
Fee Amount
$1,270.00
$4.50
$279.40
$1,553.90
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
Fee Amount
$10.00
$15.00
$4.00
$50.00
$10.00
$10.00
$10.00
$10.00
Permit Total Fees: $119.00
Project Number: 01004463 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
Plumbing Permit
Contractor: GEORGE H WHITE CONST Finn: GEORGE HARVARD WHITE CON
Address: 0 BOX 52 Phone: (509) 255-9204
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:
Units Unit Desc
4 NUMBER OF
7 NUMBER OF
1 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Printed By: MKC
Permit Total Fees:
Fee Amount
$24.00
$42.00
$6.00
$18.00
$6.00
$6.00
$6.00
$6.00
$12.00
$126.00
Print Date: 6/8/2001
Fee Amount Invoice Amount Amount Paid Amount Owing
$1,553.90 $1,553.90 $0.00 $1,553.90
$119.00 $119.00 $0.00 $119.00
$126.00 $126.00 $0.00 $126.00
$1,798.90 $1,798.90
$0.00 $1,798.90
rb;.t i
SPOKE COiJN Y
Project Description:
CI —1-M0'3/LH&
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
(uYt s f r (Axis t ... r x_ a3 c tf r
TYPE OF APPLICATION
ATTAcCiee 5
54 Building Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
0 Tenant (New/Change)
0 Other
SPECIFIC SITE INFORMATION
Street Address: OS -4 S i ,e ((e ( L. V1 Le_ L A v.; -e— 1,/e ig 1) a Le W A
Assessor's Tax Parcel Number(s): 1 9 9l i 3 7
Legal Description:a
L 0-1- 3
t
Rd
— Yl1)1)kTk 0Wl Sele I/e-L L. ,:i. -�
Depattment Use Only
Mailing Address:
Water District/Purveyor:
Sewer District/Purveyor
City, State, Zip
Total habitable space
37 3
Road width
Setbacks
Front: Rear:
Left: Right:
School District
Fire District:
Mailing address
George
White, Inc.1! K.
W
Zoning
OWNER/APPLICANT INFORMATION
0 Indicate who should he contacted regarding this project
0 Owner:
Phone:
Fax:
El Applicant:
Phone:
Pr1yr ` e` Fax:
Mailing Address:
# of stories 2
Mailing Address:
City,CiState, Zip
Dimensions
6 0 y 52._
City, State, Zip
Total habitable space
37 3
TContractor
Phone
Faaxax
❑ Architect/Engineer
Phone
Mailing address
George
White, Inc.1! K.
W
Mailing address
Construction type
City, State Zip
/Bay 52
Wa- 99019Contact
City, State Zip
Cost of project
X72
r�
State ContracLi
Lie
Lake,
name:
PROJECT INFORMATION
Building Information
Building height to peak
27 /
# of stories 2
Main floor sq. ft.
/20 CP
Unfinished basement sq. ft.
/.,,/s---
Dimensions
6 0 y 52._
Total habitable space
37 3
:"'i floor sq. ft.
113
Finished basement sq. ft.
Occupancy group/7_3
Construction type
Garage sq. ft. V
Deck sq. ft.
/
Cost of project
X72
CO '
Heat source (electric, gas, etc.)
6A S ror c f
fl
Manufactured Home
Width:
Length:
Sign
What is the square footage of the sign
face?
Year:
Make:
# of signs
How high is the sign?
Area of existing signs
Relocation
Fire Safety
Firm Name
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes No
Previous address
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes Pr No
Paint booth
Fire Sprinkler
Tent
Fire Alarm
Fireworks display
Address
Proposed use
Value
Special Inspections Required?
Non -Residential Energy Code Compliance?
Firm Name
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes No
Phone
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes Pr No
Plans Examiner
Phone
Inspectors:
Are critical or hazardous materials used or stored on site?
0 Yes ):irNo
Address
Inspector
Phone
D Concrete
D Welding
D Bolting
D Reinforcement
Address
ADDITIONAL SITE INFORMATION
Are there structures on the property? D Yes No
If yes, identify on site plan
What is the current property size? 'j v
(square feet or acres)
What is the current use of this property?
S L o T
Will the site be served by a septic system? 0 Yes ®' No
Is any part of the property within 250 feet of a shoreline?
If yes, identify on site plan D Yes X No
Is your property in a designated wildlife habitat area?
0 Don't know 0 Yes 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 0 No
Are or will there be wells located on the property?
If yes, identify on the site plan 0 Yes Pr No
Are there any wetlands, streams or ponds within 200 feet of the
property?
If yes, identify on site plan D Yes fit No
Is there evidence of fill or excavation oi: the property?
Cl Yes ig!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 ):irNo
DEPARTMENT USE ONLY
Is the property in a designated Stortnwater Control Area?
DYes 0 N
Is public sewer available to the site? D Yes D No
Is the property inside the ASA?
0 Yes
D Yes
0 No
0 N
Is public water available to the site? D Yes D 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 D No
Date Received:
Staff Representative:
for the PutP°Kedt /7 /
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dir a si P"r structures wands,
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indicatedat water:300p stapes or other ;caa ad
ZONE:
FRONT
COmmFLANKING
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69, 7 /
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