2003, 03-21 Permit App: 03001865 ResidenceProject Number: 03001865 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/21/2003 Page 1 of 3
Project Information:
.................................
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 26 Left: 5 Right: 5 Rear:
Site Information:
Plat Key: Name:
Parcel Number: 45245.2609
Contact: GEORGE 11 WHITE, INC
Address: BOX 52
C - S - Z: LIBERTY LAKE WA 99019
Phone: (509) 921-9752
Group Name:
Project Name:
Block: 1 ii Lot. 9
SiteAddress: 855 S SHELLEY LAKE LN
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Area: 22,944 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: ::.............
District: F
Owner: Name: GEORGE 11 WHITE, INC
Address: BOX 52
LIBERTY LAKE WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 30
Review
Site PlcReview
Released By:
Plan Review
Released By
Approach / Drainage
93M/ a7
Sewer Review P i i <.) 0
( s? -4
Permits:
Released By
'CZ ilueP
Operator: JAS Printed By: JAS Print Date: 3/21/2003
Project Number: 03001865 Inv: 1
'Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Date: 3/21/2003 Page 2 of 3
Contractor: GEORGE 11 WHITE CONST
Address: 0 BOX 52 Phone: (509) 921-9752
LIBERTY LAKE, WA 99019
Building Characteristics
Const Category: New Group: Type:
Nbr Of Dwellings: Occupant Load: Building Height:
Bldg W x D: x Building Sq Ft: Sprinklers: 0
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp lug Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VN 1,755 $21,586.50 1,755 $21,586.50
DECK R-3 VN 180 $1,409.40 180 $1,409.40
GARAGE U-1 VN 832 $9,984.00 832 $9,984.00
RESIDENCE R-3 VN 1,755 $115,830.00 1,755 $115,830.00
Firm: GEORGE HARVARD WHITE CON
Stories:
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
GAS LOG OR GAS INSERT
HOOD -TYPE II
Totals: 4,522 $148,809.90 4,522 $148,809.90
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Fee Amount
$1,140.00
$4.50
$250.80
Permit Total Fees: $1,395.30
Mechanical Permit
Units
1
1
3
4
1
1
1
Operator: JAS Printed By: JAS
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$12.00
$3.00
$40.00
$10.00
$10.00
$10.00
$95.00
3/21/2003
Project Number: 03001865 Inv: 1
Application
THIS IS NOTA PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/21/2003
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
Notes:
Payment Summary: <:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Units
3
5
3
1
1
1
1
1
1
3
Page 3 of 3
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
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:
Fee Amount Invoice Amount
$1,395.30 $1,395.30
$95.00 $95.00
$120.00 $120.00
$1,610.30 $1,610.30
Fee Amount
$18.00
$30.00
$18.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$0.00
$120.00
Amount Owing
$1,395.30
$95.00
$120.00
$1,610.30
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: JAS Printed By: JAS
Print Date: 3/21/2003
1 1
Ainik
SPOKANE Cou
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description:
N� LA -J RP—S' i A ,v c -e— Giw 3 c.4-1 A-11- G, frit
TYPE OF APPLICATION
jBuilding 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:
55 s. S (nz c (e,f L A kt L N CedAda-t e GtJ4 911037
Assessor's Tax Parcel Number(s):
Legal Description:
L cis
Fire District:
OWNER/APPLICANT INFORMATION
El Indicate who should be contacted regarding this project
❑ Owner: Phone:
5 At -vv"- Fax:
❑ Applicant:
Phone:
Fax:
Mailing Address:
Mailing Address:
City, State, Zip
City, State, Zip
❑ Contractor Phone
George JL. Wfite%Falnc.
0 Architect/Engineer
Phone
Fax
Mailing address
Bo 52
Mailing address
City, State Zip fide L �L 'Wa 99019
City, State Zip
WA State Contractor license N
coe.D ►^/ Ei t,v ti.Q 9 i P s
Contact name:
Building height to peak
2 7'
Dimensions
# of stories
PROJECT INFORMATION
Building Information
Main floor sq. ft.
/ 7 5s
Unfinished basement sq. ft.
2
Total habitable space
2nd floor sq. ft.
Finished basement sq. ft.
Occupancy roup
-.3
Construction typ
Garage sq. ft.
Deck sq. ft.
c.
Cost of project
,L(9 l2 p )
Heat source (electric, gas, etc.)
+A S.
1 c 4-3c_ t.--/ C Tsif ,!to 0 pa
e•17.//re- q2.:/ • 74r2 11..1_,___VJ-1. 7. 7 67
311CI O't 't" 140( )1 Ct.:5/
7