2003, 09-24 Permit: BLd-03-02571 Residence*Wane
Spokane
41 0 Val ley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
NEW SINGLE FAMILY RESIDENTIAL PERMIT
Job Address: 921 S SHELLEY LAKE LN
SPOKANE VALLEY WA 99206
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner: CLIFF SCHMITZ CONSTRUCTION
Applicant: CLIFF SCHMITZ CONSTRUCTION
Address:
Lot:
Contractor: CLIFFORD SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT LN
VERADALE WA 99037-
Blk: Parcel No:
Phone: (509) 999-7733
Phone:
Lic No:
(509) 922-4297
CLIFFSC104RF
/9
Permit #: BLD -03-02571
Applied:
Issued:
Expires:
Zoning:
09/24/2003
09/25/2003
03/23/2004
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
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
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
sfr
143748
21
65 X 58
1
3
25
61
5
5
r-3
5-w
1
75 X 143
no
no
3
3
1
5
1
1
1
1
3
1
1
1
3
3
1
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
Total Calculated:
Deposits/Receipts:
Total Due:
496.06
1,240.15
4.50
18.00
18.00
6.00
30.00
6.00
6.00
6.00
6.00
18.00
15.00
10.00
10.00
3.00
30.00
1,922.71
1,922.71
0.00
THIS IS NOT A RECEIPT
crrv` ix i�`� a ,
Spokane
�,.•�Valley
NEW SINGLE FAMILY RESIDENTIAL PERMIT
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206 Permit #: BLD -03-02571
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, st a or/lo/cal laws, codes or ordinances.
Ownership of resulting development rights granted by any issued per n}t inure thq/prdperty wn
Print Name Signature", �/ ,, / Date
Staff Initials
THIS IS NOT A RECEIPT