2003, 03-31 Permit App: 03002131 ResidenceProject Number: 03002131 Inv:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/31/2003 Page 1 of 3
Project Information:
Permit Use: RESIDENCE/ATTACHED GARAGE - FORCED Contact: GEORGE H. WHITE INC
AIR GAS Address: BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Setbacks: Front 25 Left: 5 Right: 5 Rear: 40 Phone: (509) 255-5000
Group Name:
Site Information: Project Name:
District: F
Plat Key: Name:
Parcel Number: 45244.2611 Block: 1
SiteAddress: 859 S SHELLEY LAKE LN
SPOKANE, WA USA 00000
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: 9,658 Sq Ft Width: 65 Depth: 153 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Lot: 11
Owner: Name: GEORGE II WHITE
Address: BOX 52
LIBERTY LAKE, WA 99019
Hold:
Review
Site Plan Review
Plan Review
Released By: /—
Approach / Drainage
Released By•
3._31
Te4,, 9.0„444k+tv- 6af
10124140
Sewer
' totfl U1C5 04)120 -0k -C. -
Released By.
Operator: RMB Printed By: RMB
Print Date: 3/31/2003
Project Number: 03002131
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Date: 3/31/2003 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:
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Group:
Occupant Load:
Building Sq Ft:
Handicap Parking:
Description Grp Tyne Notes
BASEMENT U R-3 VN
DECK R-3 VN
GARAGE U-1 VN
RESIDENCE R-3 VN
Item Description
STATE SURCHARGE
RESIDENTIAL SURCHARGE
RESIDENTIAL VALUATION
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
Type:
Building Height: Stories:
Sprinklers: u
Critical Materials:
This Application: Total Project:
So Ft Valuation Sq 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
Totals: 4,179 $139,425.00 4,179 $139,425.00
Units
1
1
1
Unit Desc
Y OR BLANK
Y OR BLANK
Y OR BLANK
Fee Amount
$4.50
$240.90
$1,095.00
Permit Total Fees: $1,340.40
Mechanical Permit
Units
1
1
5
5
1
1
1
Operator: RMB Printed By: RMB
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
$5.00
$50.00
$10.00
$10.00
$10.00
$107.00
3/31/2003
Project Number: 03002131 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/31/2003
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
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Units
3
6
2
1
1
1
1
1
1
2
Fee Amount
$1,340.40
$107.00
$114.00
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:
Invoice Amount
$1,340.40
$107.00
$114.00
Fee Amount
$18.00
$36.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$12.00
Amount Paid
$0.00
$0.00
$0.00
$114.00
Amount Owing
$1,340.40
$107.00
$114.00
$1,561.40 $1,561.40 $0.00 $1,561.40
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: RMB Printed By: RMB
Print Date: 3/31/2003
ATI
SPOKE CowrY
PROJECT APPLICATION
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
Project Description:
t t_ J RP_S A C.c) 3 c4 -1A -11 --
TYPE
4-1A-tTYPE OF APPLICATION
XBuilding Permit
❑ Change in Use
❑ Grading
❑ Manufactured Home Permit
❑ Relocation
❑ Sign
❑ Tenant (New/Change)
❑ Other
SPECIFIC SITE INFORMATION
Street Address:
Assessor's Tax Parcel
Legal Description:
epa
me
s -c1 S S lt `r L kt L N Ck(a dA- k C)4" 9,637
Number(s): `4 S a . 2 �e 1,/
Low
se c
Water District/Purveyor:
SchooFDistrict.
Sewer District/Pury
Fire District:
OWNER/APPLICANT INFORMATION COS X I 5 ct, to 57
El Indicate who should be contacted regarding this project
0 Owner:AA Phone:
5. 4,e Fax:
0 Applicant:
Phone:
Fax:
Mailing Address:
Mailing Address:
Dimensions_
City, State, Zip
City, State, Zip
Finished basement sq. ft.
0 Contractor Phone
George /iteFaly..
❑ Architect/Engineer
Phone
Fax
JL
Mailing address
Box 52
Mailing address
Heat source (electric, gas, etc.)
City, State Zip Liberty Laic, `14a. 99019
City, State Zip
WA State Contractor license #
Contact name:
PROJECT INFORMATION
Building Information
Building height to peak
c2.-/ t
# of stories
/
Main floor sq. ft.
/ate s
Unfinished basement sq. ft.
/G 3 G0
Dimensions_
Total habitable space
2"d floor sq. ft.
Finished basement sq. ft.
Occupancy group
g.
Constructiott typ
Garage sq. ft. �a
Deck sq. f
Cost of project
Heat source (electric, gas, etc.)
AD D ,S51.
ZONE "SP u -.e
ROAD WIDTH 2O
FRONTFLANKING
COMN
REV!EVvF
for 'The purpose of
. :t 1:thd correct
repreppt_ttHe of the orr AH kricieet tiroperty
linesi'diratoisitriris. curb iiio.ts ititeictureer asements
have boor Hrettitiori ,ittioirtlic rite viiellaert3,
bodies or stee-,-; or othor cribcai areas.
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