2005, 01-27 Permit App: 05000259 ResidenceProject Number: 05000259 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE - Contact: GEORGE WHITE CONSTRUCTION INC
NATURAL GAS Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Setbacks: Front 20 Left: 6 Right: 10 Rear: 25 Phone: (509) 991-0429
Group Name:
Site Information: Project Name:
Plat Key:
Date: 01/27/2005 Page 1 of 3
Name: SHELLEY LAKE 04TH ADD PUD
District: East
Parcel Number: 45244.3001 Block: 2
SiteAddress: 904) SHELLEY LAKE LN
Location:: CSV
Zoning: UR -3.5
Water District:
Area: 11,294 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot: 1
Owner: Name: GEORGE WHITE CONSTRUCTIO
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 32
Review
Site Plan Review
Released By: C)I,
oLl'.Ytr;.,1 Q
Plan Review
Released>Bv
Approach / Drainage
Sewer Review
Permits:
Released By:
01577.111(;;;L.
Operator: K_C Printed By: K_C Print Date: 01/27/2005
Project Number: 05000259
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 01/27/2005 Page 2 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Group: R-3 Type: VB
Total Area 4316
Building Height 22
Stories 1
Dwelling Units 1
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Description Gni Type Notes
BASEMENT U R-3 VB
CARPORT U-1 VB
GARAGE U-1 VB
RESIDENCE R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: S & R HEATING
Address: 15501 N YALE RD
MEAD, WA 99021
Item Description
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
This Application:
Total Project:
Sq Ft Valuation Sq Ft Valuation
2,158 $32,370.00 2,158 $32,370.00
144 $2,160.00 144 $2,160.00
870 $16,530.00 870 $16,530.00
2,158 $161,159.44 2,158 $161,159.44
Totals: 5,330 $212,219.44 5,330 $212,219.44
Units
1
1
1
Unit Desc
SELECT
SELECT
SELECT
Permit Total Fees:
Mechanical Permit
Units
1
1
4
1
5
1
1
1
Operator: K_C Printed By: K_C
Fee Amount
$1,626.55
$4.50
$650.62
$2,281.67
Firm: S & R HEATING, INC
Phone: (509) 467-3960
Unit Desc
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$10.00
$12.00
$4.00
$12.00
$50.00
$10.00
$10.00
$10.00
$118.00
Print Date: 01/27/2005
Project Number: 05000259 Inv: 1 Application Date: 01/27/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: PRECISE MECHANICAL Firm: PRECISE MECHANICAL
Address: 1310 S AVALON CT Phone: (509)922-9666
SPOKANE WA 99216
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 4 NUMBER OF $24.00
SINKS 7 NUMBER OF $42.00
SHOWERS 1 NUMBER OF $6.00
TUBS 3 NUMBER OF $18.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
WATER USING DEVICES 2 NUMBER OF $12.00
Permit Total Fees: $126.00
Notes
Payment Summary
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $2,281.67 $2,281.67 $0.00 $2,281.67
Mechanical Permit $118.00 $118.00 $0.00 $118.00
Plumbing Permit $126.00 $126.00 $0.00 $126.00
$2,525.67 $2,525.67 $0.00 $2,525.67
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: K_C Printed By: K_C Print Date: 01/27/2005
.001/galley
STREET ADDRESS:
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206...
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
7'C i S JLu I/ &Arwi
46-r / fC-o 6/.— 2 5/72.-7Z1/7/ y - -
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: f)112 -1A--, ((
i�II DrNG PERMIT
EIRELOCATION
DCHANGE '.IN USE GRADING
(]-SIGN Q -TENANT
0 MANUFACTURED HOME
00U:tat
OWNER / APPLICANT INFORMATION
O OWNER: 61:2•70, 1 �a ,T ( f
PHONE: I )- V q a / FAX: %�I - 177 4.
ADDRESS: 1"'` D �t 52/ a r3, LAN- WA
CITY,STATE, ZIP
CONTRACTOR:
SAm�_.
APPLICANT: SL"�
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
Q ARCHITECT.: 3,41/14 -.2" ----
PHONE:
» /''4=�`
PHONE: FAX: PHONE: FAX:
ADDRESS:
CITY, .STATE, ZIP
WA ST CONTRACTOR LICENSE # 662-012 6a /'" ® 9 1 P Z�
ADDRESS:
CITY, STATE, ZIP
CONTACT:
COST OF PROJECT: /6-4
BUILDING HEIGHT TO PEAK: �? /
BUILDING DIMENSIONS:4/9Y 6 7
NUMBER OF STORIES: J
NUMBER of BEDROOMS: 3
FLANKING SETBACK:
FRONT SETBACK: 2 0
REAR SETBACK:
LEFT SETBACK:
'
RIGHT SETBACK: /6
30% SLOPES ON PROPERTY: Ni 4
OCCUPANCY GROUP:
CONSTRUCTION TYPE:6. F47 L!
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:) 9 9
CURRENT PROPERTY USE: 1,-0
CURRENT SEPTIC USE: jL. L
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA: tVI
MAIN FLOOR SQFT:2) SD
2N0 FLOOR SQ FT: "'C-
UNFIN BASEMENT:
FINISHED BASEMENT
GARAGE: 8'70
COVERED D�G'K
s�p� : I LJy
DECK:
PLUMBING PERMIT APPLICATION
a �ne Phone: (509) 688-0036; FAQ(: (509) 688-0037
�Al For Inspections, Call (509) 688-0054
Project Address:
Owner 60,
704/ ni
P, 1A1 is P t k C Phone (Daytime Contact):
Mailing Address: 'eQ
City
Contractor.- /L c// /Y- L/fT16Ocense#:
Mailing Address:
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
99 1— U q 6Ca0`4."
State Zip Code
Phone #:PON "rock
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1_
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
I
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
i
X
$6.00
=
8
GARBAGE DISPOSAL
)
X
$6'00
=
9
WATER SOFTENERX
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICALi
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
J
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
nATF•
0 VISA 0 MASTERCARD
EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Sikh'
ne�
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509 J 688-0037
For Inspections, CaII (509) 688-0054
Project Address: 70 7 9-}Z-:--2_,LL" f L -P P ? L
Owner. CO L} U. N w N. / T L t•
Mailing Address:_>� aY176 / LA-
Contractor:
A Contractor: 574 /QQ »/' r
Mailing Address:
6/ Cit
/r
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact): 9 q / -C/5/.2 G%
City
License #: Phone #:
State
Zip Code
Zip Code
AUTHORIZED SIGNATU
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000 _
/
X
$12.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
315.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
350.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
3100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or Tess than 400,000
X
350.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
3100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
,
X
320.00
=
9
BOILER/REFRIGERATION
501 -1,000M BTU
X
325.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
_ _
X
$35.00
=
11
BOILERIREFRIGERAT1ON
More than 1,750M BTU
X
$60.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
i
X
$10.00
=
13
RANGE
'
X
310.00
=
14
DRYER
X
310.00
=
15
FUEL BURNING WATER HEATER
I
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
9
X
31.00
=
18
DUCT SYSTEMS
/
X
$10.00
=
19
VENTILATING FANS
C
X
310.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
315.00
=
22
EVAPORATIVE COOLERS
/
X
310.00
=
23
TYPE I HOOD
X
350.00
=
24
TYPE I1 HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
f
X
312.00
=
26
AIR CONDITIONER
3-15 TON
X
320.00
=
27
AIR CONDITIONER
15-30 TON
X
325.00
28
AIR CONDITIONER
30-50 TON
X
335.00
=
29
AIR CONDITIONER
More than 50 TON
X
360.00
=
30
LPG STORAGE TANK
X
310.00
=
31
WOOD OR PELLET STOVEJINSERT
X
310.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS
•
X
315.00
=
34
VENTILATION SYSTEMS
X
312.00
=
35
VENTILATION MECHANICAL EXHAUST
X
312.00
=
36
INCINERATOR - RESIDENCE
X
319.00
=
37
INCINERATOR - COMMERCIAL
X
322.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK OVISA 0 MC
CARD #: �, ��/� +
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EX PIRES:
TOTAL PERMIT FEE DUE:
. -,
AUTHORIZED SIGNATU
SPoKli1£ CO1 TY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 904 S SHELLEY LAKE LN
Parcel Number: 45244.3001
Subdivision:
Block: 2 Lot: 1
Zoning: UNK Unknown
Owner: GEORGE H WHITE INC
Address: BOX 52
LIBERTY LAKE, WA
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 05000416 Inv: 1 Issue Date: 1/28/2005
Permit Use: SEWER CONNECTION - SHELLEY LAKE 4TH
Applicant: GEORGE H. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019
Contact: GEORGE H. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019
Setbacks - Front:
Group Name:
Project Name:
Left: Right:
Phone: (509) 255-5000
Phone: (509) 255-5000
Rear:
1 Permits 1
Sewer Connection Permit
Contractor: J L HAWKINS EXCAVATING
License #: JLHAWE*222LE
SEWER CONNECTION 1 $85.00 PROCESSING FEE 1 $15.00
Total Permit Fee: $100.00
FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES 8:30-5:00 PM MONDAY THRU FRIDAY
Call for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRED.
Contractor or applicant is to field locate and confirm the elevation and position of sewer stub prior to any other excavation.
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main
sewer. Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure.
This permit must be presented to the job site inspector for verification. To locate buried cables, gas piping, water lines, ctc.
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE "CALL BEFORE YOU DIG" CENTER BE
NOTIFIED. CALL BEFORE YOU DIG AT LEAST 2 WORKING DAYS IN ADVANCE, (509)456-8000.
Spokane County Code requires the installer comply with all requirements of the Washington State Dept of Labor and Industries,
including those related to trench safety.
1 Payment Summary
1
Total Fees AmountPaid AmountOwing
$100.00 8100.00 $0.00
Tran Date Receipt # Payment Amt
1/28/2005 361 $100.00
Processed By: BURRIS, ROBIN
Printed By: WENDEL, GLORIA Page 1 of 1
PERMIT
ADORES (jt Itut,L ,,
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REVIEWED BY C (1,
COMMENTS
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