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2003, 03-20 Permit App: 03001814 Residence1 Project Number: 0300181-1 Inv: 1 Application Date: 3/20/2003 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ............................................................... Permit Use: RESIDENCE/ATTACHED GARAGE - FORCED AIR GAS Setbacks: Front 25 Left: 15 Right: 6 Rear: 30 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: 45244.2701 Block: 3 SiteAddress: 858 S SHELLEY LAKE LN SPOKANE, WA USA 00000 Location:: SPO Zoning: UR -3.5 Water District: Area: 9,557 Sq Ft Urban Residential 3.5 Lot: 1 Owner: Name: GEORGE H. WHITE INC Address: BOX 52 LIBERTY LAKE, WA 99019 Hold: ❑ Width: 85 Depth: 113 Right Of Way (ft): 30 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Released' O10 Ekr--44 0I4tCS Released By42. Approach / Drainage Permits: Released, By: (ATI UY(€ S P,.©kh4-L o X2.5 32/0 Operator: RMB Printed By: RMB Print Date: 3/20/2003 Project Number: 03001814 Inv: 1 Application Date: 3/20/2003 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 Nbr Of Dwellings: Bldg W x D: x Req Parking: Description BASEMENT U COV DECK GARAGE RESIDENCE Gm R-3 R-3 U-1 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 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 Type: Building Height: Sprinklers: Critical Materials: a Stories: This Application: Total Project: So Ft Valuation Sq Ft Valuation 1,726 $21,229.80 1,726 $21,229.80 114 $1,147.98 114 $1,147.98 704 $8,448.00 704 $8,448.00 1,733 $114,378.00 1,733 $114,378.00 Totals: 4,277 $145,203.78 4,277 $145,203.78 Units Unit Desc 1 Y OR BLANK 1 Y OR BLANK 1 Y OR BLANK Permit Total Fees: Mechanical Permit Units 1 1 3 5 1 1 Operator: RMB Printed By: RMB Fee Amount $1,125.00 $4.50 $247.50 $1,377.00 Firm: GEORGE HARVARD WHITE CON Phone: (509) 921-9752 Unit Desc NUMBER OF NUMBER OF # OF UNITS NUMBER OF NUMBER OF NUMBER OF Permit Total Fees: Print Date: Fee Amount $10.00 $12.00 $3.00 $50.00 $10.00 $10.00 $95.00 3/20/2003 Project Number: 03001814 Inv: 1 Application Date: 3/20/2003 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 Item Description TOILETSBIDETS 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 6 1 2 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 $1,377.00 $1,377.00 $95.00 $95.00 $120.00 $120.00 $1,592.00 $1,592.00 Fee Amount $18.00 $36.00 $6.00 $12.00 $6.00 $6.00 $6.00 $6.00 $6.00 $18.00 Amount Paid $0.00 $0.00 $0.00 $120.00 Amount Owing $1,377.00 $95.00 $120.00 $0.00 $1,592.00 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: 3/20/2003 :IihkOH SPOIL COUNTY Iiicl Project Description: PROJECT APPLICATION SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMEN ,, 1026 WEST BROADWAY AVENUE `tr•i ,�� SPOKANE, WA 99260 509-477-3675 Ale LA -7 RP_S i A icgiv z. -e_.. t'.c w 3 c 4-1 f A- c...k& TYPE OF APPLICATION XBuilding Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit ❑ Relocation ❑ Sign 0 Tenant (New/Change) 0 Other SPECIFIC SITE INFORMATION Street Address: g58 s skt_c(€, Assessor's Tax Parcel Number(s): L Ice.. L kJ C) - A4 d (e 14)4914-o37 Legal Description: SOT 1 °artinen Water District/Purveyort PLk3 �sayc�, flo/ 3126 4dac 'bnr-, Sewer District/Purveyor Setbacks 04^ 'Front tiJ "Zoning OWNER/APPLICANT INFORMATION El Indicate who should be contacted regarding this project 75x 11 -c1, 557 0 Owner: Phone: 5• 4e...... Fax: 0 Applicant: Phone: Fax: Mailing Address: Mailing Address: Dimensions _ City, State, Zip City, State, Zip Finished basement sq. ft. 0 Contractor Phone George '14G iteFalnc• 0 Architect/Engineer Phone Fax JL. Mailing address ! Box 52 Mailing address Heat source (electric, gas, etc.) City, State Zip Liberty LaC*,c, 4a. 99019 City, State Zip WA State Contractor license N ceorci4b),5 9i ff3 Contact name: PROJECT INFORMATION Building Information Building height to peak .-7' # of stories ( Main floor sq. ft. i s,..3 Unfinished basement sq. ft. / "2 Co Dimensions _ Total habitable space 2°' floor sq. ft. Finished basement sq. ft. Occupancy grow o'� Construction ty e!J 1% Garage sq. ft. 4( �D b k sq. ft. P X11 n 2c') Cost of project Heat source (electric, gas, etc.) ire All I•r-. AD D H 35?-Sk441 ZONE ROAD ` F F ePS7 ANKING 15 GO M: tfi SKe L1LI 5/4/2- z flP/e z_oor 5,14z-2zz1 z/1 -A -z- VI/672 ,A9.0*-4Pi2verli PO , C n I T. \ 71V E • , Gk../ !4 ;17--e- J5-70(, 5:2-41g, LA', k.,14, 990/9