2005, 05-25 Permit app: 05001802 ResidenceProject Number: 05001802 Inv: 1
'Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/25/2005 Page 1 of 4
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -
NATURAL GAS
Setbacks: Front 20 Left: 5.5 Right: 5 Rear: 40
Site Information:
Plat Key:
Contact: GEORGE H WHITE CONSTRUCTION
Address: PO BOX 52
C - S - Z: LIBERTY LAKE, WA 99019
Phone: (509) 991-0429
Group Name:
Project Name:
Name: SHELLEY LAKE 4TH ADD PUD
District: East
Parcel Number: 45244.2903 Block: 1
SiteAddress: 909 E SHELLEY LAKE LN
Location:: CSV
Zoning: UR -3.5
Water District:
Area: 8,941 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Lot: 3
Owner: Name: GEORGE H WHITE CONSTRUCTI
Address: PO BOX 52
LIBERTY LAKE, WA 99019
Hold: ❑
Depth: 0 Right Of Way (ft): 32
Review
Site Plan Review
Released By:
Plan Review
Released By:
Ja},RiltAA,L
Flood plain
•
Released By:
Sewer Review
Permits:
Released By: r D
Operator: K_C Printed By: K_C Print Date: 05/25/2005
Project Number: 05001802 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/25/2005 Page 2 of 4
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 3852
Building Height 24
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Su Ft Valuation
BASEMENT U R-3 VB 1,926 $28,890.00 1,926 $28,890.00
DECK R-3 VB 160 $2,400.00 160 $2,400.00
GARAGE U-1 VB 500 $9,500.00 500 $9,500.00
RESIDENCE R-3 VB 1,926 $143,833.68 1,926 $143,833.68
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Totals: 4,512 $184,623.68 4,512 $184,623.68
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Flood Plain
Fee Amount
$1,469.75
$4.50
$587.90
$2,062.15
Contractor: GEORGE H WHITE CONST Firm: GEORGE HARVARD WHITE CON
Address: 0 BOX 52 Phone: (509) 921-9752
LIBERTY LAKE, WA 99019
Item Description Units Unit Desc Fee Amount
FLOOD PLAIN PERMIT 1 NUMBER OF $50.00
Permit Total Fees: $50.00
Operator: K_C Printed By: K_C Print Date: 05/25/2005
Project Number: 05001802 Inv: 1
' Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/25/2005 Page 3 of 4
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
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
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
Mechanical Permit
Firm: S & R HEATING, INC
Phone: (509) 467-3960
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
4 # OF UNITS
1 NUMBER OF
5 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Fee Amount
$10.00
$12.00
$4.00
$12.00
$50.00
$10.00
$10.00
$10.00
$10.00
$128.00
Firm: PRECISE MECHANICAL
Phone: (509) 922-9666
Units Unit Desc
2 NUMBER OF
5 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Operator: K_C Printed By: K_C
Fee Amount
$12.00
$30.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
Permit Total Fees: $102.00
Print Date: 05/25/2005
Project Number: 05001802
Notes:
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/25/2005 Page 4 of 4
Payment Summary:
Permit Type
Building Permit
Flood Plain
Mechanical Permit
Plumbing Permit
Fee Amount
$2,062.15
$50.00
$128.00
$102.00
Invoice Amount
$2,062.15
$50.00
$128.00
$102.00
$2,342.15 $2,342.15
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$2,062.15
$50.00
$128.00
$102.00
$0.00 $2,342.15
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: 05/25/2005
31:01110.°4174;
STREET ADDRESS:
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: 4 -07 -
PERMIT
-0 f
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/NG D/VIS/ON
11707East Sprague Ave Ste 106
Spokane Va//ey, WA 99206
Phone: (509)688-0036FaX: (509)688-0037
REQUIRED SITE INFORMATION
see. 41416
c- / � SIL.
PERMIT DESCRIPTION.
&B ANG PERMIT
DRELOCA TION
1:1GE.Dr.USE D GING
DSIGN
-TENANT
ROWNER 6t---71/ H i
FAX
PHONE:, q
ADDRESS: l.� O Y
Ia., ) E e.-1 ~
CONTRACTOR:
PHONE:
ADDRESS:
OWNER / AP ANTIN OF R
FAX:
MANZFACTURED HOME
DOTHER
CTY,STATE ZIP
a APPLICANT:_
PHONE:
ADDRESS:
ARC
PH
T.:
FAX:
,CITY, STATE, ZIP
CITY, STATE, ZIP ADORE
WA S7 CONTRACTOR LICENSE # '( +r 1 Kd,
-- — ---_- coNTa �' f
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: q7/
ISNUMBUILDING DIMENSIONS:1 7Y CI-
NUMBER
BER OF STORIES:
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK:
REAR SETBACK:
7
RIGHT SETBACK:_
LEFT SETBACK:
30% SLOPES ON PROPERTY: -6 `
OCCUPANCY GROUP:.
CONSTRUCTION TYPE: °)
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
.CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE: L 6 1
CURRENT SEPTIC USE:
CURRENT WELL USE:
IMPERVIOUS SURFACE AREA:
MAIN FLt3OR SQ FT: l ` y-.
2ND FLOOR SQ FT "4"--t` ''
UNFIN BASEMENT 1, 9-2-C
FINISHED BASEMEN
GARAGE: SSG °
COVERED ppDECK:
DECK;=1 6 X t
MANUFACTURED HOME SIGN
. .
I DTH: LENGTH: SQ FT OF SIGN: HEIGHT OP SIGN:
EAR: PIT SET: # OF SIGNS: AREA OF EXIST SIGN:
ANUFACTURER: TYPE OF SIGN:
RELOCATION FIRE SAFETY
REVIOUS ADDRESS:
ROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
VA STATE NON-RESIDENTIAL ENERGY CODE
11
'LANS EXAMINER: PHONE: FAX
iDDRESS:
CITY, STATE, ZIP
NSPECTOR: PHONE: FAX:
DDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
0 BOLTING °CONCRETE ° REINFORCEMENT 0 WELDING
FIRM NAME:
INSPECTOR(S):
PHONE: FAX:
BUILDING -STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: 0 0 -YES NO IF YES: 0 COUNTY 0 CITY
IS PUBLIC WATER AVAILABLE: 0 YES 0NO IF YES, WHICH WATER DISTIIRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PFtOPERTY LOCATED WITHIN ASA: 00
YES NO . PSSA: 0 YES EI NO
METHOD OF PAYMENT:
0
CASH CHECK
BAN/(CARO//;
AUTHORIZED SIGNATURE.
EXPIRES: ' VIN #
*FAXED PERMIT APPLI ILL•ONLY ACCEPTED, INITIVMAJOR BANKCARD
S fit a l'Ise\'`
Project Address: 70
Owner: Com`, "-/ Lk)
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 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): / %/ OY2 ci
Mailing Address: G S L i f , , ') �� ' 9
Contractor. PR i { Afs'T , tif 11\ v-,1 r9C State
License #: Phone #:
Mailing Address:
Zip Code
DESCRIPTION OF WORK
TOILETS
2 URINALS
3 TUBS
WATER CLOSET, BIDETS
City State
# OF
UNITS
4 SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
COST
36.00
X $6.00
X $6.00
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
36.00
$6.00
TOTAL
AMOUNT
6 DISHWASHER
7 CLOTHES WASHER
8 GARBAGE DISPOSAL
9 WATER SOFTENER
10 ELECTRIC HOT WATER TANK
11 FLOOR DRAINS
NOTE IF GAS, SEE MECHANICAL
AREA, CASE, COIL TRENCH,
CONDENSATE
36.00
X 36.00
X 36.00
X $6.00
X 36.00
36.00
12
13
14 WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
15 SEWAGE EJECTOR
ROOF DRAINS/OVERFLOW DRAINS
FOUNTAINS, DRINKING
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
GRINDER SUMP PUMP
WATER USING DEVICE
CROSS CONNECTION DEVICE
$6.00
X 56.00
36.00
ICE A • R COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
INTERCEPTORS
MEDICAL GAS . - r outlet
MISCELLANEOUS PLUMBING FIXTURE
METHOD OF PAYMENT:
❑ CASH 0 CHECK
DATE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
VACUUM BREAKER, CHECK
VALVE, AND R.P-B.P.D. FOR
VATS TANKS BOILERS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
NITROUS, OXYGEN
36.00
ArVisA❑ MASTERCARD
EXPIRES:
SUBTOTAL
PROCESSING FEE 335.00
TOTAL PERMITTEE DUE:
Zip Code
Sfitikane
4.0$17alley
Project Address: 7‘) 547,e/4#14¢
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 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:
Phonee(Daytime Contact): ? /4-'5111 1.
Owner: ( , he tA) 1-,I) -77), C•
Mailing Address: / y
Contractor. S f �C h' License #:
Mailing Address:
City _ State
Phone*:
Zip Code
DESCRIPTION OF WORK
1
FUEL BURNING APPLIANCE
2
FUEL BURNING APPLIANCE
Equal to or less than 100,000
3
UNLISTED APPLIANCE (Additional Fee)
More than 100,000
City State
# OF
UNITS
Equal to or less than 400 000
4
5
6
UNLISTED APPLIANCE (Additional Fee)
USED APPLIANCE (WSEC min. AFUE
Wig)
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400 000
Equal to or less than 400,000
7
BOILER/REFRIGERATION
More than 400,000
1-100M8111
X
X
X
X
X
X
X
COST
015.00
$19.00
$50.00
TOTAL
AMOUNT
$100.00
050.00
0100.00
8
9
10
11
13
14
15
16
BOILER/REFRIGERATION
101-500MBTU
BOILER/REFRIGERATION
501 - 1,000M BTU
BOILER/REFRIGERATION
1,001 - 1,750M BTU
BOILER/REFRIGERATION,
GAS LOG, GAS INS, GAS FIREP,t4CE
More than 1,750M BTU
X
X
X
X
X
515.00
028.00
039.00
$57.00
$95.00
RANGE
)
DRYER
FUEL BURNING WATER HEATER
MISC. FUEL BURNING APPLIANCE
17
GAS PIPING (each outlet)
18 DUCT SYSTEMS
X
X
X
X
X
x
$1000
$10.00
$10.00
$10.00
010.00
01.00
19
VENTILATING FANS
20
21
22
23
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include ducting)
EVAPORATIVE COOLERS
TYPE HOOD
Equal to or less than 10,000 CFM
Greater than 10,000 CFM
X
X
X
X
1
X
24
25
TYPE II HOOD
HEAT PUMP/AIR CONDmONER
0-3 TON
X
X
$10.00
$10.00
$12.00
019.00
010.00
$50.00
$10.00
26
27
28
AIR CONDmONER
3-15 TON
1
AIR CONDmONER
15-30 TON
AIR CONDITIONER
30-50 TON
29
30
31
32
AIR CONDmONER
LPG STORAGE TANK
More than 50 TON
WOOD OR PELLET STOVE/INSERT
X
X
X
X
X
X
WOOD STOVE - FREE STANDING
METHOD OF PAYMENT:
0 CASH 0 CHECK [VISA 0 MC
CARD #
AUTHORIZED SIGNATURE:
DATE
EXPIRES:
X
X
SUBTOTAL
$12.00
$20.00
$25.00
$35.00
$60.00
010.00
$10.00
$25.00
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
Zip Code
SpoKANE
CouNTY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 909 E SHELLEY LAKE LN
arcel Number: 45244.2903
Subdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: C&G PART/RICE,G/SCOTBERG,N/SHE
Address: 406 S SHELLY LAKE LN
VERADALE, WA 99037-
uilding Inspector: BOBBY STONE
Water Dist: UNKNOWN
Project Number: 05002040 Inv:
Permit Use: SEWER CONNECTION
1 Issue Date: 4/1/2005
Applicant: GEORGE H. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019
Contact: GEORGE H. WHITE INC
BOX 52
LIBERTY LAKE, WA 99019
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Phone: (509) 255-5000
Phone: (509) 255-5000
Rear:
Permits
1
wer 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.
Payment Summary
Tran Date
4/1/2005
1
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Processed By: HOWARD, DAN Page 1 of 1
Printed By: WENDEL, GLORIA
Receipt # Payment Amt
1654 $100.00
PERMIT
•
q I
ADDRESS k(-481
ZONE 1)4_, •
ROAD WID1445
FRONT Oi FLANKING IA, h -
COMMENTS
REVIEWED BY /.1
13A-&10114,--nir F 0 a L--,-z-ezi 9.o 27 &Ili.,
Leo 26°27
h site plan is being submitted for the purpose of
fining a building permit and is a true and correct
esentation of the proposal. All known property
dimensions, curb lines, structures and easements
ve been identified. Also indicated are wetlands,
odies of water, steep slopes or other critical areas.
to'
7/.3S'
9? 7 3-/-/1-z-‘z7
ZOT E ZOCAr _C/4/4 --e("/ fft
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