2004, 06-30 Permit: BLD-04-04831 ResidenceSpok�.ne
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11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
NEW SINGLE FAMILY RESIDENTIAL PERMIT
Job Address: 919 S SHELLEY LAKE LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - GAS
Subdivision: Lot:
Owner:
Applicant:
Address:
Contractor:
Address:
GEORGE H WHITE INC
GEORGE H WHITE INC
PO BOX 52
LIBERTY LAKE, WA 99019-0052
GEORGE H WHITE INC
PO BOX 52
LIBERTY LAKE WA 99019-0052
Blk: Parcel No:
Phone: (509) 921-9752
Phone:
Lic No:
Permit #: BLD -04-04831
(509) 921-9752
GEORGHWO91 P8
Applied:
Issued:
Expires:
Zoning:
06/30/2004
07/13/2004
01/08/2005
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
HEAT PUMP/AIR COND 0 - 3 TON
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
CURRENT PROPERTY USE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
sfr
163387
1
1
1
4
1
1
1
1
2
4
1
1
22
56 X 37
1
2
22
60
9
12
r-3
5-b
1
70 X 143
RESIDENCE
no
no
2
2
1
5
1
Fees:
PLAN CHECK FEE
TYPE II HOOD
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
HEAT PUMP/AIR COND 0 - 3 TON
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
Total Calculated:
Deposits/Receipts:
Total Due:
540.86
10.00
10.00
10.00
10.00
2.00
40.00
12.00
1,352.15
4.50
12.00
12.00
6.00
30.00
6.00
6.00
6.00
6.00
24.00
15.00
2,114.51
2,114.51
0.00
THIS IS NOT A RECEIPT
f7TY OF�
Spokane
....i*Villey
NEW SINGLE FAMILY RESIDENTIAL PERMIT
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206 Permit #: BLD -04-04831
Disclaimer:
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of
Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued ermit inure to the property own
1 Lc2- ir li‘ 7 g
Print Name
Staff Initials
LCA—Le
Signatu e
THIS IS NOT A RECEIPT