2003, 03-19 Permit App: 03001798 ResidenceProject Number: 03001798 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Contact: GEORGE H WHITE INC
Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019-0052
Phone: (509) 000-0000
Group Name:
roject Name:
Date: 3/19/2003 Page 1 of 3
Permit Use: RESIDENCE W/GARAGE - GAS
Setbacks: Front 25 Left: 5 Right: 5 Rear:
Site Information:
Plat Key: Name:
Parcel Number: 45245.2610
SiteAddress: 857 S SHELLEY LAKE LN
VERADALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District 010 VERA
Area: 13,459 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Block: 1 i Lot: 10
Owner: Name: GEORGE H WHITE INC
Address: PO BOX 52
LIBERTY LAKE, WA 99019-0052
District: F
Hold: ❑
Depth: 0 Right Of Way (ft): 30
Review
Site Plan Review
Release
TTi�IISS �._
Plan Review
Released By
Approach / Drainage
33,1/41se
Sewer Review p\j12)
Permits:
Released By:
Operator: JAS Printed By: JAS Print Date: 3/19/2003
Project Number: 03001798
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/19/2003 Page 2 of 3
Contractor: GEORGE H 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:
Description Gtr
BASEMENT U R-3
DECK R-3
GARAGE U-1
RESIDENCE R-3
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Type Notes
VN
VN
VN
VN
Item Description
STATE SURCHARGE
RESIDENTIAL SURCHARGE
RESIDENTIAL VALUATION
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Item Description
DUCT SYSTEMS
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
Type:
Building Height: Stories:
Sprinklers: 0
Critical Materials:
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,778 $21,869.40 1,778 $21,869.40
168 $1,315.44 168 $1,315.44
704 $8,448.00 704 $8,448.00
1,830 $120,780.00 1,830 $120,780.00
Totals: 4,480 $152,412.84 4,480 $152,412.84
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Fee Amount
$4.50
$255.20
$1,160.00
Permit Total Fees: $1,419.70
Mechanical Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: JAS Printed By: JAS
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$10.00
$12.00
$3.00
$12.00
$30.00
$10.00
$10.00
$10.00
$107.00
3/19/2003
Project Number: 03001798 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/19/2003 Page 3 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Item Description
TOILETSB1DETS
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 Unit Desc
2 NUMBER OF
5 NUMBER OF
1 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Fee Amount
$1,419.70
$107.00
$108.00
Permit Total Fees:
Invoice Amount
$1,419.70
$107.00
$108.00
$1,634.70 $1,634.70
Fee Amount
$12.00
$30.00
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$108.00
Amount Owing
$1,419.70
$107.00
$108.00
$0.00
$1,634.70
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and fmds 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: 3/19/2003
( ►
Ark
SPOKANE COUNTY
Project Description:
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFwEtErwE
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
3
Il1C' e.� RP s R ru c -e-.
TYPE OF APPLICATION
X Building Permit
❑ Relocation
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
Street Address:
❑ Sign
❑ Tenant (New/Change)
❑ Other
SPECIFIC SITE INFORMATION
/a 5 7 S Skt.tiel L* Ice. Lk) uefgdA-k t)4 90a,
Assessor's Tax Parcel Number(s):
Legal Description:
L 0 1 /0
LAC_ 1 304
SetbacksJ§
Front:
School' District:
Fire District:
OWNER/APPLICANT INFORMATION
0 Indicate who should be contacted regarding this project
PROJECT INFORMATION
Building height to peak
r
Dimensions_
Occupadcy group
# of stories
Building Inforination
Co 2
Total habitable space
3&oe
Cost of project
132 2 5c ,
Construction type
V
Main floor sq. ft.
/830
2"d floor sq. ft.
Garageft
Unfinished basement sq. ft.
sq. . -� 67
Heat source (electric, s(etc.)
Finished basemen sq. ft.
Deck sq.).6 Q
Phone:
❑ Owner:1
5 4y...1/te....'e.. Fax:
CIApplicant:
Mailing Address:
Phone:
Fax:
Mailing Address:
City, State, Zip
City, State, Zip
Phone❑Architect/Engineer
CI Contractor
H. >hiteFalyle•
Phone
Fax
George
Mailing address
52
,O.F7
ing addretLc
C�
i
��lBoa-
City,State ZipCity,
Liberty Lai, `Wa. 99019
State Zip
L_ l_ OS
WA State Contractor license #
Contact name:
i
PROJECT INFORMATION
Building height to peak
r
Dimensions_
Occupadcy group
# of stories
Building Inforination
Co 2
Total habitable space
3&oe
Cost of project
132 2 5c ,
Construction type
V
Main floor sq. ft.
/830
2"d floor sq. ft.
Garageft
Unfinished basement sq. ft.
sq. . -� 67
Heat source (electric, s(etc.)
Finished basemen sq. ft.
Deck sq.).6 Q
LOT
I-4 L
L iKfi
IIT