2005, 02-18 Permit App: 05000539 ResidenceProject Number: 05000539 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 02/18/2005 Page 1 of 3
Project Information:
Contact: WHITE, GEORGE H INC
Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019-0052
Phone: (509) 991-0429
Group Name:
Project Name:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -
NATURAL GAS
Setbacks: Front 20 Left: 18 Right: 17 Rear: 23
Site Information:
Plat Key: Name: SHELLEY LAKE 04TH ADD PUD
District: East
Parcel Number: 45244.3002 Block: 2
SiteAddress: 906 E SHELLEY LAKE LN
Location:: CSV
Zoning: UR -3.5
Water District:
Area: 8,783 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: v:._r
Lot: 2
Owner: Name: WHITE, GEORGE H INC
Address: PO BOX 52
LIBERTY LAKE, WA 99019-0052
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Site Plan Review
Plan Review
Released By:
eik Aciwzget2i/t/(
Approach / Drainage
Released By:
d'Yj
Sewer Review
Permits:
Operator: K_C Printed By: K_C Print Date: 02/18/2005
Project Number: 05000539
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 02/18/2005 Page 2 of 3
Contractor: GEORGE H WHITE CONST
Address: 0 BOX 52
LIBERTY LAKE, WA 99019
Building Characteristics
Group: R-3
Total Area
Building Height
Stories 1
Dwelling Units 1
Type: VB
3679
22
Description
BASEMENT U
CARPORT
GARAGE
RESIDENCE
Building Permit
Firm: GEORGE HARVARD WHITE CON
Phone: (509) 921-9752
Grp Type Notes
R-3 VB
U-1 VB
U-1 VB
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
1,800 $27,000.00 1,800 $27,000.00
144 $2,160.00 144 $2,160.00
870 $16,530.00 870 $16,530.00
1,879 $140,323.72 1,879 $140,323.72
Totals: 4,693 $186,013.72 4,693 $186,013.72
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Units
1
1
4
1
5
1
1
1
Operator: K_C Printed By: K_C
Fee Amount
$1,480.95
$4.50
$592.38
$2,077.83
Firm: S & R HEATING, INC
Phone: (509) 467-3960
Unit Desc Fee Amount
NUMBER OF $10.00
NUMBER OF $12.00
# OF UNITS $4.00
NUMBER OF $12.00
NUMBER OF $50.00
NUMBER OF $10.00
NUMBER OF $10.00
NUMBER OF $10.00
Permit Total Fees:
Print Date:
$118.00
02/18/2005
Project Number: 05000539 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 02/18/2005 Page 3 of 3
Contractor: PRECISE MECHANICAL
Address: 1310 S AVALON CT
SPOKANE WA 99216
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Notes,..,.
Payment Summary
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firm: PRECISE MECHANICAL
Phone: (509) 922-9666
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
2 NUMBER OF
Permit Total Fees:
Fee Amount Invoice Amount
$2,077.83
$118.00
$96.00
$2,077.83
$118.00
$96.00
Fee Amount
$12.00
$30.00
$6.00
$12.00
$6.00
$6.00
$6.00
$6.00
$12.00
$96.00
'MIN= Z","....; a53' a. 7 .
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$2,077.83
$118.00
$96.00
$2,291.83 $2,291.83 $0.00 $2,291.83
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: 02/18/2005
i•tor‘,
doondllej'
1
I—
T
PERMIT APPLICATION WORK SHEET
D�fANEVALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
1 11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206..
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:7of S �L�L L7 fl) L
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: 4 G 1- 2 IS (-0 Gi- 2 5 1&e...by
PERMIT DESCRIPTION: f111 -7-3-1A-1
I9I U�,DING
PERMIT acHANGE'IN USE ... GRADING
SIGN O TENANT
CI -RELOCATION
D MANUFACTURED HOME
CI- 0HIER...
OWNER / APPLICANT INFORMATION
E OWNER: 6&-r0, , W fr L t (,
�-f/� � q b
APPLICANT: 5"
PHONE: 1 )- 4 G/ FAX: ��- 177
_ PHONE: FAX:
ADDRESS: F s 2J Lei Lir ADDRESS:
CITY,STATE, ZIP CITY, STATE, ZIP
CONTRACTOR: -5-4m t-- ARCHITECT.: S�'/-i// �=�-
PHONE: FAX:
PHONE: FAX:
ADDRESS:
ADDRESS:
CITY,. STATE, ZIP �^/ CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # �4,C .Lv6)4"�.il 0 9 ,� P? CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: /64 Da
BUILDING HEIGHT TO PEAK: �? /
BUILDING DIMENSIONS:4/gJ/ G 7
NUMBER OF STORIES: f
NUMBER of BEDROOMS:
FLANKING SETBACK:
3
FRONT SETBACK: 2 6
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
'
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:. ► l �^
CONSTRUCTION TYPE:V" 13. 1" O )T, �,�vt/ 1
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
N0.
CURRENT PROPERTY SIZt -2Q q-3
CURRENT PROPERTY USE: VO
CURRENT SEPTIC USE: L'` L
CURRENT WELL USE: V (-JV
TL
IMPERVIOUS SURFACE AREA: S .
MAIN FLOOR SQ FT: •'"
2ND FLOOR SQ FT:
UNFIN BASEMENT:]
FINISHED BASEMENT_
GARAGE:70
1p� LH
COVERED sDiiC1(:
DECK:
Project Address:
Owner: C L
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
96 6 Sfzr _, / -P r' L-_
, U, /4, ',j/ - l T L i.
Mailing Address:
Contractor:
Mailing Address:
1 e? 0
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact): i 67/'C /2 1
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 Tess than 100,000
/
X
$12.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or Tess than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or Tess than 400,000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
L =
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
1
X
$10.00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
1
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
9
X
$1.00
=
18
DUCT SYSTEMS
/
X
$10.00
=
19
VENTILATING FANS
C
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or Tess than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
=
22
EVAPORATIVE COOLERS
/
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
/
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
33
REPAIR & ADDITIONS•
X
$15.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK Oil/ISA 0 MC
CARD t. -.,-...-.. 1,x,r
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:`
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATU
Project Address:
Owner l%,�,
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Mailing Address:
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
G,,3 ? ° c • Phone (Daytime Contact):
\ft 9611
‘(.) �.► �. L �,
„ ,1— /,1 t do?“..
Ci5y
L
� / �'t /,S1 'tterAlfl
Contractor. "� � ��-� License #:
Mailing Address:
State Zip Code
Phone #: t0 Al 'CO C v
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
i
DESCRIPTION OF WORK
# OFUNITSX
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
/2_
(
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
J..'"
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
j
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$5.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
/
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 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
i
Ark
SPOIL COUNTY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
1
Site Address: 906 S SHELLEY LAKE LN
Parcel Number: 45244.3002
Subdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: GEORGE H WHITE INC
Address: BOX 52
LIBERTY LAKE, WA 99019
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 05000415 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:
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, etc.
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
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date
1/28/2005
Processed By: BURRIS, ROBIN
Printed By: WENDEL, GLORIA Page 1 of 1
Receipt #
361
Payment Amt
$100.00
PERMIT
pPorrr- ---0
-7 -6 11
ADDRESS
ZONEkROAD WIDTH
FRONT RANKING
COMMENTS 1 ft
- L REVIEWED BY
•
LOT 2
BLK 2
SHELLEY LAKE 4TH
8 5 16
58 I *5-7:f
08 E
SITfp LA N
7 C .1-1Y
SCALE: 1
65-
q,9 t-q7c.t
477