2005, 04-12 Permit App: 05001155 ResidenceProject Number: 05001155 Inv: 1
•
Application
Date: 04/12/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -
NATURAL GAS
Setbacks: Front 20 Left: 8 Right: 10 Rear: 24
Site Information:
Plat Key:
Contact: GEORGE H. WHITE INC
Address: BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Phone: (509) 255-5000
Group Name:
Project Name:
Name: SHELLEY LAKE 4TH ADD PUD
District: East
Parcel Number: 45244.3003 Block: 2
SiteAddress: 908 S SHELLEY LAKE LN
Location:: CSV
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Area: 7,968 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot: 3
Owner: Name: C&G PARTNERSHIP/RICE, GRAN
Address: 406 S SHELLY LAKE LN
SPOKANE VALLEY, WA 99037 -
Hold: ❑
Depth: 0 Right Of Way (ft): 32
Review
Site Plan Review
Released By:
Plan Review
Sewer Review
Permits:
Released By:,
Operator: K_C Printed By: K_C Print Date: 04/12/2005
Project Number: 05001155 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 04/12/2005 Page 2 of 3
Building Permit
Contractor: GEORGE H WHITE CONST Firm: GEORGE HARVARD WHITE CON
Address: 0 BOX 52 Phone: (509) 921-9752
LIBERTY LAKE, WA 99019
Building Characteristics
Group: R-3 Type: VB
Total Area 3239
Building Height 22
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Su Ft Valuation
BASEMENT U R-3 VB 1,566 $23,490.00 1,566 $23,490.00
CARPORT U-1 VB 120 $1,800.00 120 $1,800.00
GARAGE U-1 VB 733 $13,927.00 733 $13,927.00
RESIDENCE R-3 VB 1,673 $124,939.64 1,673 $124,939.64
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Totals: 4,092 $164,156.64 4,092 $164,156.64
Units Unit Desc Fee Amount
1 SELECT $1,357.75
1 SELECT $4.50
1 SELECT $543.10
Permit Total Fees:
Mechanical Permit
$1,905.35
Contractor: S & R HEATING Firm: S & R HEATING, INC
Address: 15501 N YALE RD
MEAD, WA 99021
Phone: (509) 467-3960
Item Description Units Unit Desc
GAS WATER HEATER 1 NUMBER OF
GAS APPLIANCE<=100,000BTU 1 NUMBER OF
GAS PIPING 4 # OF UNITS
HEAT PUMP OR A/C 0-3 TONS 1 NUMBER OF
VENTILATING FANS 5 NUMBER OF
EVAPORATIVE COOLERS 1 NUMBER OF
CLOTHES DRYER 1 NUMBER OF
RANGE 1 NUMBER OF
GAS LOG OR GAS INSERT 1 NUMBER OF
Fee Amount
$10.00
$12.00
$4.00
$12.00
$50.00
$10.00
$10.00
$10.00
$10.00
Permit Total Fees: $128.00
Operator: K_C Printed By: K_C Print Date: 04/12/2005
Project Number: 05001155 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 04/12/2005
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 PIPING - DWV
Notes:
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Page 3 of 3
Firm: PRECISE MECHANICAL
Phone: (509) 922-9666
Units Unit Desc
2 NUMBER OF
4 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount Invoice Amount
$1,905.35 $1,905.35
$128.00 $128.00
$84.00 $84.00
Fee Amount
$12.00
$24.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
Amount Paid
$0.00
$0.00
$0.00
$84.00
Amount Owing
$1,905.35
$128.00
$84.00
$2,117.35 $2,117.35 $0.00 $2,117.35
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: 04/12/2005
*lane
--- 7
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)68 0036 Fax: (500)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: L % 3
/
PERMIT DESCRIPTION: h VITI_-'
IN -BUILDING PERMIT CI CHANGE IN USE IJ GRADING
-SIGN 0 -TENANT
DRELOCATION
0 MANUFACTURED HOME
®-OfJ ER
OWNER / APPLICANT INFORMATION
OWNER: Cl r r �f,} "1. )p< (r
PHONE: 1 FAX:
71
ADDRESS: V 0 i S" ,
CONTRACTOR:
PHONE ChrY) FAX:
ADDRESS:
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE # ',
C TY,STATE, ZIP
APPLICANT:
PHONE:
ADDRESS:
9
FA :
lI
ARCHITECT:
PHONE:
C
TATE, ZIP
ADDRESS:
CITY, STATE, ZIP -
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 1)6,60
BUILDING HEIGHT TO PEAK: 22 /'
BUILDING DIMENSIONS:I/ 7" C
NUMBER OF STORIES: '/
NUMBER of BEDROOMS: 2'
FLANKING SETBACK:
^1 /
FRONT SETBACK: 2-0
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
S!.
30% SLOPES ON PROPERTY: 't
—
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY: C=
CRITICAL AREAS:
CURRENT PROPERTY SIZE: 7/ vrR
CURRENT PROPERTY USE: L-
CURRENT SEPTIC USE:
CURRENT WELL USE: '}
IMPERVIOUS SURFACE AREA: f�
MAIN FLOOR SQ FT: / '(e' 7 3
2N0 FLOOR SQ FT:
UNFIN BASEMENT:C�
FINISHED BASEMENT:
GARAGE:
COVERED D C
I%
DECK:
(1),
Project Address: , 708 5,84-24/ 0,4- '-
Owner: Ke;t'l' . /7.1, /A.J i-11 T .77Y C•
Mailing Address: e(j)( S2 4030.727/ tJrGr
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Developmentepa t s ion
Building11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit
Use:
Phone (Daytime Contact):
990/
City State
Phone #:
1 --
Contractor: J t t 1-1 L7 License #:
Mai ing Address:
?9/-1 .2 /
Zip Code
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF `
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or Tess than 100,000
/
X
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100 000
X
519.00
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less 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 less than 400,000
X
550.00
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION----- ------,---.More
than 1,750M BTU
X
$95.00
=
12
,��''°"
"'�
GAS LOG, GAS INS1�tT, GAS FIREPLACE--
X
$10 00
13
RANGE
)
X
$10.00
14
DRYER
X
$10.00
=
15
6-0
FUEL BURNING WATER HEATER v 6 P"C .
/
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
/
X
$1.00
16
DUCT SYSTEMS
/
X
$10.00
=
19
VENTILATING FANS
S
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 indude ducting) Greater than 10,000 CFM
X
$19.00
22
EVAPORATIVE COOLERS
/
X
510.00
23
TYPE [HOOD
X
$50.00
=
24
TYPE 11 HOOD
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER 0-3 TON
/
X
512.00
=
26
AIR CONDmONER 3-15 TON
X
520.00
27
AIR CONDITIONER 15-30 TON
X
525.00
=
28
AIR CONDITIONER 30-50 TON
X
535.00
=
29
AIR CONDITIONER More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK (VISA 0 MC
CARD u
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
"lane
4.'1/alley
Project Address:a:
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development
De rt m ont
Buildin11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
ermit Use:
Owner: 6 `' , 2 Phone (Daytime Contact): %/ dy2ci
Mailing Address:G S12, L I t ' i � q /
h�C,t„ State Zip Code
Contractor.
RLC 1 C ' AlLicense #: �' Phone #:
Mailing Address:
City
State
BANKCARD NUMBER: �....
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
a
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
36.00
=
2
URINALS
X
36.00
=
3
TUBS
/
X
36.00
=
4
SHOWERS (PER TRAP)
BATH, STALL ON-SfTE BUILT
2'
X
36.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
'
X
36.00
=
6
DISHWASHER
/
X
36.00
=
7
CLOTHES WASHER
/
X
$6.00
=
8
GARBAGE DISPOSAL
)
X
36.00
=
9
WATER SOFTENER
X
$6.00
=
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
36.00
=
13
FOUNTAINS, DRINKING
X
36.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
36.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
36.00
=
16
WATER USING DEVICE
ICE AN R COFFEE MAKER,
X
36.00
=
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR
VATS, TANKS, BOILERS
X
36.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
36.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
36.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
36.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
naTF•
../ ISA 0 MASTERCARD
EXPIRES: _
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER: �....
AUTHORIZED SIGNATURE:
Zip Code
SPECIAL INSPECTIONS I
MANUFACTURED HOME
SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION
FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER:
PAINT BOOTH:
FIREWORKS DISPLAY:
FIRE ALARM:
TENT:
BLASTING:
DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER:
PHONE: FAX:
ADDRESS:.
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
❑ BOLTING
FIRM NAME:
INSPECTOR(S):
0 CONCRETE
0 REINFORCEMENT
PHONE:
0 WELDING
FAX:
BUILDING STAFF USE ONLY
1
IS PUBLIC SEWER AVAILABLE: ES 0 NO
IF YES: 0 COUNTY0 CITY -
IS PUBLIC WATER AVAILABLE: YES 0 NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: 0 YES ❑ NO
DATE:
METHOD OF PAYMENT:
❑ ❑
CASH CHECK
BANKCARD
1
STAFF:
EXPIRES: VIN Al
AUTHORIZED SIGNATURE- //! A ..---.
*FAXED PERMIT APPLIC IONS ONLY ACCEPTED WITH MAJOR BANKCARD
FROM : GHW INC
kat
Srol;ANT, COON rY
1
rH? NU. • JYJ77c17r ro
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050 J�
Site Information
Site Address: 908 E SHELLEY LAKE LN
Parcel Number: 45244.300:.
Subdivision:
Block: Lot:
Zoning: UNK Unlatown
Owner: C&G PAR'INERSHIP/RJCE, GRANT/SC
Address: 406 S SHELLY LAKE LN
VERADAI,E, WA 99037 -
Building Inspector: BOBBY STONE
Water Dist:
1
Sewer Connection Permit
Project Information
Project Number: 05002037 Inv: 1 Issue Date: 4/1/2005
Permit Use: SEWER CONNECTION
Applicant: GEORGE H. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019 Phone: (509) 255-5000
Contact: GEORGE 11. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019 Phone: (509) 255-5000
Setbacks - Front: Left: Right: Rear:
Group Name:
Project Name:
Permits
Contractor: 1 L HAWICINS EXCAVATING License 11: 1LHAWE`222LE
SEWER CONNECTION 1 585.00 PROCESSING FEE 1 515.00
Total Permit Fcc: 8100.00
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 i.: to field locate and confirm the elevation and position of sewer stub prior to any other excavation.
Sewer stubs are to be chocked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main
sewer. Sewer lines shou d be constructed to allow for gravity flow from the lowest level of the structure.
This permit must be presyntcd 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 Libor and Industries,
including those related to trench safety.
1
Payment Summary
Total Fees Amours .Paid AmountOwing Tran Date Receipt #
8100.00 $100.00 S0.00 4/1/2005 1654
Processed By: HOWARD, DAN
Printed By: WRNDEL, GLORIA
APR 05 2005 10:54
Page 1 of 1
Payment Amt.
8100.00
PERMIT
5099219776 PAGE.02
L Lt;
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Signed: er, s clued are wetIrds,
Date:
er e
This site plan is being4itted for the purpos of
obtaining a building. What and is a true and co ect
representation of pieproposal. All known pro erty
lines/dimenslaos, c d. structures and easem nts
hays been id ied. Als
bodies of w p spas or othcritical aas.
(,1" .
- rzt /2 y e
17/.4
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