2002, 01-30 Permit App: 02000561 Residence '/6 I/4406
Project Number: 02000561 Inv: 1 Application Date: 1/30/02 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: RESIDENCE W/GARAGE-NATURAL GAS Contact: LANZCE G DOUGLASS INC
Address: 815 E ROSEWOOD AVE
C-S-Z: SPOKANE,WA 99208
Setbacks: Front 20 Left: 10 Right: 7 Rear: 38 Phone: (509)483-6532
Group Name:
Site Information: Project Name:
Plat Key: 005862 Name: SHELLEY LAKE District: F
Parcel Number: 45242.1713 Block: 7 Lot: 13
SiteAddress: 16004 E 6TH LN Owner:Name: LANZCE G DOUGLASS INC
VERADALE,WA USA 99037 Address: 815 E ROSEWOOD AVE
Location::VER SPOKANE,WA 99208
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 7,700 Sq Ft Width: 70 Depth: 110 Right Of Way(ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review //�� i
Site Plan Review Released By: C_e �--CA. -k-Q... _ _! -
Plan Review I Released By: �.40
Approach/Drainage Released By: ► Q ,�►
Sewer Review Released By:
Permits:
Operator: CKF Printed By: CKF Print Date: 1/30/02
Project Number: 02000561 Inv: 1 Application Date: 1/30/02 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: LANZCE G DOUGLASS,INC Firm: LANZCE G DOUGLASS,INC
Address: 8510 N CRESTLINE Phone: (509)483-6532
SPOKANE,WA 99217
Building Characteristics
Const Category: New Group:R-3 Type: VN
Nbr Of Dwellings: 1 Occupant Load: Building Height: Stories: 1
Bldg W x D: 40 x 52 Building Sq Ft: 1872 Sprinklers: ❑
Req Parking: Handicap Parking: Critical Materials: El
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VN 936 $10,820.16 936 $10,820.16
DECK R-3 VN 120 $883.20 120 $883.20
GARAGE U-1 VN 480 $5,760.00 480 $5,760.00
RESIDENCE R-3 VN 936 $58,032.00 936 $58,032.00
Totals: 2,472 $75,495.36 2,472 $75,495.36
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $742.50
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $163.35
Permit Total Fees: $910.35
Mechanical Permit
Contractor: DANCAR MECHANICAL INC. Firm: DANCAR MECHANICAL INC.
Address: 311 N HODGES RD Phone: (509)924-9921
GREENACRES,WA 99016
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 4 NUMBER OF $40.00
CLOTHES DRYER 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $95.00
Operator: CKF Printed By: CKF Print Date: 1/30/02
Project Number: 02000561 Inv: 1 Application Date: 1/30/02 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: GOLD SEAL MECHANICAL INC Firm: GOLD SEAL MECHANICAL INC
Address: 5524 E BOONE AVE Phone: (509)535-5944
SPOKANE,WA 99212
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 3 NUMBER OF $18.00
SINKS 4 NUMBER OF $24.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
CROSS CONNECTION DEVICES 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Permit Total Fees: $102.00
Notes:
OCCUPANCY IS DENIED ON ALL LOTS UNTIL FURTHER NOTICE FROM DIV. OF UTILITIES
PER GENE REPP 3/26/97 CKF OK TO ISSUE SEWER PERMITS FOR: BLOCK 2 - LOTS 3
THROUGH 10& 1,2 BLOCK 3 - LOTS 1 THROUGH 7 BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH
6& 19 BLOCK 6 - LOTS 1 THROUGH 10
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $910.35 $910.35 $0.00 $910.35
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $102.00 $102.00 $0.00 $102.00
$1,107.35 $1,107.35 $0.00 $1,107.35
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 contrued 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: CKF Printed By: CKF Print Date: 1/30/02
Project Number: 02000559 Inv: I Application Date: 1/30/02 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SEWER CONNECTION-SHELLEY LAKE Contact: LANZCE G DOUGLASS INC
Address: 815 E ROSEWOOD AVE
C- S-Z: SPOKANE,WA 99208
Setbacks:Front Left: Right: Rear: Phone: (509)483-6532
Group Name:
Site Information: Project Name:
Plat Key: 005862 Name: SHELLEY LAKE District: F
Parcel Number: 45242.1713 Block: 7 Lot: 13
SiteAddress: 16004 E 6TH LN Owner: Name: LANZCE G DOUGLASS INC
VERADALE,WA USA 99037 Address: 815 E ROSEWOOD AVE
Location::VER SPOKANE,WA 99208
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: HI
Area: 7,700 Sq Ft Width: 70 Depth: 110 Right Of Way(ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Review by Utilities Released By: FE
, V 041)6'2—
Permits:
Sewer Connection Permit
Contractor: CANNON EXCAVATING INC Firm: CANNON EXCAVATING INC
Address: PO BOX 28778 Phone: (509)467-6522
SPOKANE,WA 99228
Item Description Units Unit Desc Fee Amount
SEWER CONNECTION 1 NUMBER OF $85.00
PROCESSING FEE 1 Y OR BLANK $15.00
Permit Total Fees: $100.00
Operator: CKF Printed By: CKF Print Date: 1/30/02
Project Number: 02000559 Inv: 1 Application Date: 1/30/02 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes:
OCCUPANCY IS DENIED ON ALL LOTS UNTIL FURTHER NOTICE FROM DIV. OF UTILITIES
PER GENE REPP 3/26/97 CKF OK TO ISSUE SEWER PERMITS FOR:BLOCK 2 - LOTS 3
THROUGH 10& 1,2 BLOCK 3 - LOTS 1 THROUGH 7 BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH
6& 19 BLOCK 6 - LOTS 1 THROUGH 10
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Connection Permit $100.00 $100.00 $0.00 $100.00
$100.00 $100.00 $0.00 $100.00
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 contrued 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: CKF Printed By: CKF Print Date: 1/30/02
MAR 28 '00 09:20AM SPK CNTY UTIL P.2/8
•
1' . _
S P O K A. N E ' tia tr'
UTILITIES DIVISION A DIVISION OF THE PUBLIC WORKS DEPARTMENT
N.Bruce Rawls,FE,Utilities Director Gary Oberg,Director
GENERAL FACILITIES CHARGE(GFC)
• PAYMENT OPTION SELECTION RECORD
PLEASE NOTE: Form must be filled out accurately and in its entirety,and signed,or a permit will not be issued.
Date: i-2 Z
Plat Name: f `fey V-'- Lot No(s): /3 Block No(s): 7
Site Address(es): _ /6 G Parcel No(s):
Z,,q/vZGE - c-c.,-7ig
Owner Name: OR Builder Name: -T�e--
PRINT Owner's Name PRINT Builder's Name
Payment Option Selected(Check One):
1. ( ) GFC payment received at issuance of Sewer Connection Permit by .
Division of Utilities
2. (X) GFC to be!paid at closing.at the GFC rate in effect at the time of closing. vp dr
3. ( ) GFC payment in 24 equal monthly payments upon establishment of Sewer Billing Account.
Complete one of the following statements.
a. Owner's Statement: I, . understand that I will be
billed for the applicable GFC amount in 24 monthly installments. The monthly GFC installments will be added
to my monthly sewer service charges.
b. Builder's Statement I, , understand that because I
am selecting this option for payment of the GFC, that the purchaser of the home will be responsible for
payment of the applicable GFC in 24 equal monthly installments. I agree to formally disclose to potential
buyers of the property that the GFC charges will be added to the monthly sewer service billings as soon as
billing commences.
Special Conditions: ( ) No ( ) Yes -See Reverse Side of Form
, -- '-y_€_,=,-f-f4.-__,,,-,-0----7--
Spokane County, GFC Payment Option Form
Division of Utilities Revised 03/06/00
1026 W. Broadway•Spokane,WA 99260-0180 • (509)477-3604 FAX: (509)477-4715 TDD: (509)324-3166
Lanzce G. Douglass,Inc. 815 E. Rosewood Ave., Spokane WA 99208-5507
House Plan: -+ 45 Rnneh 5p/11 Address: C. I(' C;1
Bedrooms: 3 Legal: LOT 13 BLOCK 7
Baths: 3 Development: fie.I/ey Z-4 iLe
Elevation: Scale: 1"=20'
Co'fi G,/t4_
- -/°r
j
111
3
13,
1 / 1
Q. - i7
This site pian is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal.All known property
lines/dimensions,curb lines,structures and easements
have •-; identified.Also indi ted are wetla •
=• w.ter steep sl• s j.' or critic.i as.
A' �, : ►2 • ice
Date: ._. 1 '30. 02.
N
I
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ADDRESS 1 6 C:)4L4 6 - (1 " Li)
-JO' ZONE
ROAD WIDTH 50
FRONT 20 FLANKING
COMMENTS _ r
REV/EWE') In' C� �7_,1 0 Sc.,