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2005, 05-09 Permit App: 05001464 Residence Project Number: 05001464 Inv: 1 Application Date: 05/09/2005 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- Contact: GEORGE H WHITE,INC. NATURAL GAS Address: PO BOX 52 C-S-Z: LIBERTY LAKE,WA 99019-0052 Setbacks:Front 20 Left: 13 Right: 11 Rear: 27 Phone: (509)991-0429 Group Name: Site Information• Project Name: Plat Key: Name: SHELLEY LAKE 04TH ADD PUD District: East Parcel Number: 45244.3011 Block: 2 Lot: 11 SiteAddress: 16513 E 9TH LN Owner:Name: GEORGE H WHITE,INC. Address: PO BOX 52 Location::CSV LIBERTY LAKE,WA 99019-0052 Zoning: UR-3.5 Urban Residential 3.5 Water District: Hold: ❑ Area: 8,365 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 32 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: : ,.. .,.. Review t Site Plan Review Released By: 1• 41'x. 1,/-{,,:.c 412 ) Plan Review Released By: t4 ) 4 vl ��� Sewer ReviewReleased By: }y Permits: �,.�, A _.... _; ... ... . . ......... .:..... ... .ten,...;�,4, ,,, - .. �_. ... � :fr Operator: K_C Printed By: K_C Print Date: 05/09/2005 Project Number: 05001464 Inv: 1 Application Date: 05/09/2005 Page 2 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: GEORGE H WHITE CONST Finn: 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 3704 Building Height 21 Stories 1 Dwelling Units 1 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation BASEMENT U R-3 VB 1,852 $27,780.00 1,852 $27,780.00 COV DECK R-3 VB 150 $2,250.00 150 $2,250.00 GARAGE U-1 VB 560 $10,640.00 560 $10,640.00 RESIDENCE R-3 VB 1,852 $138,307.36 1,852 $138,307.36 Totals: 4,414 $178,977.36 4,414 $178,977.36 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $1,436.15 STATE SURCHARGE 1 SELECT $4.50 RESIDENTIAL PLAN REVIEW 1 SELECT $574.46 Permit Total Fees: $2,015.11 Mechanical Permit Contractor: S&R HEATING Firm: S&R HEATING,INC Address: 15501 N YALE RD Phone: (509)467-3960 MEAD,WA 99021 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 4 #OF UNITS $4.00 HEAT PUMP OR A/C 0-3 TONS 1 NUMBER OF $12.00 VENTILATING FANS 5 NUMBER OF $50.00 CLOTHES DRYER 1 NUMBER OF $10.00 RANGE 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: $128.00 Operator: K_C Printed By: K_C Print Date: 05/09/2005 Project Number: 05001464 Inv: I Application Date: 05/09/2005 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Plumbing Permit Contractor: PRECISE MECHANICAL Firm: PRECISE MECHANICAL Address: 1310 S AVALON CT Phone: (509)922-9666 SPOKANE WA 99216 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 2 NUMBER OF $12.00 SINKS 4 NUMBER OF $24.00 SHOWERS 2 NUMBER OF $12.00 TUBS 1 NUMBER OF $6.00 DISH WASHERS 1 NUMBER OF $6.00 GARBAGE DISPOSAL 1 NUMBER OF $6.00 CLOTHES WASHER 1 NUMBER OF $6.00 FLOOR DRAINS 1 NUMBER OF $6.00 WATER USING DEVICES 1 NUMBER OF $6.00 Permit Total Fees: $84.00 Payment Summary „ Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $2,015.11 $2,015.11 $0.00 $2,015.11 Mechanical Permit $128.00 $128.00 $0.00 $128.00 Plumbing Permit $84.00 $84.00 $0.00 $84.00 $2,227.11 $2,227.11 $0.00 $2,227.11 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: 05/09/2005 L -Ll SOY olfkan , , (-_ - I ( tt _ , 0 D J PERMIT APPLICATION WORK SHEET MAY G # 203 a SPOKANE VALLEY COMMUNITY DEVELOPMENT D BUILDING DIV/S/ON ) 0 uoLndma 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: 1 `P ( i A 11E-Ir ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: L-01- I \, .ec.Qu iSH/2.,7 y C - PERMIT DESCRIPTION: 11 U-1,--) 'R- S ' BUILDING PERMIT a CHANGE IN USE ®GRADING a MANUFACTURED HOME 0RELOEATION 0-SIGN ©-TENANT 0OThJ R I OWNER /APPLICANT INFORMATION —.......f °R° OWNER: 6� :0 e 9 / vi I 7.1:::7 4 ' 0 APPLICANT: F I PHONE: .19 0/ 4/ FAX 47.61,2 *7 7 PHONE FAX: ADDRESS:t °Y S ai ADDRESS: M ). f:.,. =�j / L-, LiA C TY,STATE,ZIP CITY,STATE,ZIP CONTRACTOR: ei ARCHITECT: C r'""- PHONE: c Arkl 6- FAX: PHONE: FAX: ADDRESS: ADDRESS: l'r,��CITY,STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE#CL' !Oe3 I CONTACT: Cdr p' 99 I // 7 f PERMIT/BUILDING INFORMATION COST OF.PROJECT: / 6. 60 0 30%SLOPES ON PROPERTY: MAIN FLOOR SQ FT:1 `% BUILDING HEIGHT TO PEAK: 2/ °/ i OCCUPANCY GROUP: 2ND FLOOR SQ FT: ��� BUILDING DIMENSIONS:^/ 7Y 5 6 CONSTRUCTION TYPE: 1)1 C4^ I L UNFIN BASEMENT: r ;g"'- `° NUMBER OF STORIES: STRUCTURES ON PROPERTY: ' FINISHED BASEMENT: NUMBER ASEMENT:NUMBER of BEDROOMS: CRITICAL AREAS: GARAGE: - - 0 �,n FLANKING SETBACK: CURRENT PROPERTY SIZE 8 (A"-- COVERED DECK: 7`'' 54 FRONT SETBACK: ) / CURRENT PROPERTY USE: 2- 6 DECK: REAR SETBACK: CURRENT SEPTIC USE: -5. LEFT SETBACK: CURRENT WELL USE: I RIGHT SETBACK: Cl IMPERVIOUS SURFACE AREA: '`' MANUFACTURED HOME SIGN WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OP SIGN: YEAR: PIT-SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: • .RELOCATION - ' ._ , . FIRE SAI=ETY' I PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: - BLASTING: DATE/TIME: 1 WA STATE NON_RESIDENTIAL"ENERGY CODE PLANS EXAMINER: PHONE: FAX: • ADDRESS:. - CITY,STATE,ZIP ' INSPECTOR: PHONE: ._ FAX: ADDRESS: CITY,STATE,ZIP LL - SPECIAL INSPECTIONS j 0 BOLTING ®CONCRETE S REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): �. F U�S�.E ONLY` -. _ � ILaING�xs.T IS PUBLIC-SEWER AVAILABLE:-" • ES NOCI IF YES:" .=©."COUNTY 0 CITY - IS PUBLIC WATER AVAILABLE: ' YES ® NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS TH.E PROPERTY LOCATED WITHIN ASA: ® YES 0 NO PSSA: 0 YES 0 NO • I DATE: I STAFF: METHOD OF PAYMENT: . El 9 El r T ®, in CASH CHECK -eirvamm BANKCARD#; EXPIRES. - VIN# AUTHORIZED SIGNATURE./ *FAXED PERMIT APPLIC ION E ONLY ACCEPTEBWITI +MA1ORBANKCARD MECHANICAL PERMIT APPLICATION k City of Spokane Valley Community Development Department Bnudi Su 1 iei 06 11707 E. Sprague Avenue, Suite 106 ley Spokane Valley, WA 99206 ,,,Valley Phone: (509)688-0036;Fax: (509)688-0037 • �/ FOR INSPECTIONS, CALL(509)688-0054 ,1 4g. /�/ Permit Use: •� Project Address: Permithone U(Daytime Contact): ?,/-61' 'y�- �1 Owner: � /?�', OV�'4 i °�,>�' '�°( •�r4� ��?, �/�/D/ I Mailing Address: lr x S� G� f" 4 '` _ State Zip Code / City Contractor. - -s't h'L31+ n° " License#: Phone#: Mailing Address: city State Zip Code #OF TOTAL UNITS X COST = AMOUNT _DESCRIPTION OF WORK Equal to or less than 100,000 X $15.00 1 FUEL BURNING APPLIANCE - 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 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 = USED APPLIANCE(WSEC min.AFUE Equal to or less than 400,000 X $50.00 = 5 rating) USED APPLIANCE(WSEC min.AFUE More than 400,000 X $100.00 = 6 rating) 7 BOILER/REFRIGERATION 1-100M BTU X $15.00 = 8 BOILER/REFRIGERATION 101-500M BTU X $28.00 , = 9 BOILER/REFRIGERATION 501-1,000M BTUX $39.00 = 1,001-1,750M BTU X $57.00 _= 10 BOILER/REFRIGERATION _ ' 11 BOILER/REFRIGERATION...---- -^,. More than 1,750M BTUX $95.00 = GAS LOG,GAS INSGT,GAS FIREPLACE-""` I X $10.00 1 X $10.00 o RANGE X $10.00 = 14 DRYER - 15 FUEL BURNING WATER HEATER 6.6 6 P-( , / X $10.00 = 16 MISC.FUEL BURNING APPLIANCE X $10.00 = - / X $1.00 = 17 GAS PIPING(each outlet) X $10.00 = 18 DUCT i SYSTE.riS X $10.00 = 19 VENTILATING FANS 20 AIR HANDLER(DOES NOT indude ducting) Equal to or less than 10,000 CFM X $12.00 = r 21 AIR HANDLER(DOES NOT include ducting) Greater than 10,000 CFM X $19.00 = 22 EVAPORATIVE COOLERS / X $10.00 = X $50.00 23 TYPE I HOOD X $10.00 , _ 24 TYPE II HOOD 25 HEAT PUMP/AIR CONDITIONER 0-3 TON 1 X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 __ ' 28 AIR CONDITIONER 30-50 TON X $35.00 ,= 29 AIR CONDITIONER More than 50 TON X $60.00 •_ 30 LPG STORAGE TANK • X $10.00 = 31 WOOD OR PELLET STOVEIINSERT _ X $10.00 = 32 WOOD STOVE-FREE STANDING X $25.00 = METHOD OF PAYMENT: SUBTOTAL DATE PROCESSING FEE $35.00 0 CASH 0 CHECK (VISA 0 MC EXPIRES: CARD#: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: ( . PLUMBING PERMIT APPLICATION • Snlial4City of Spokane Valley Community Development Department �+ BuildingDivision • 11707 E. Sprague Avenue, Suite 106 - del ValleYSpokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 NF FOR INSPECTIONS, CALL(509)688-0054 Project /6:Addressl Permit Use: Owner:- °, H, L- i-3 i C i "' Phone (Daytime Contact): 7�6y2� Ste. L1WS, ch- , , A.. 47gei Mailing Address: C..1?('' State Zip Code P I i C ¶ "c /M VI r cl Phone#: Contractor. V R I- L I ' License#: Mailing Address: City State Zip Code #OF TOTAL DESCRIPTION OF WORK , UNITS X COST = AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6.00 = X $6.00 = 2 URINALS / 3 TUBS .X $6.00 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT �' X $6.00 = 5 SINKS - LAVS/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, ilX $6.00 = JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT 6 DISHWASHER i x $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL / X $6.00 X $6.00 = 9 WATER SOFTENER 10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA,CASE COIL TRENCH, / X $6.00 = CONDENSATE , 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X 56J00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = 16 WATER USING DEVICE (ICE ANR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X $6.00 = CARBONATOR,SWAMP COOLER _ 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE AND R.P.B.P.D.FOR: X $6.00 = VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X . $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: SUBTOTAL 0 CASH 0 CHECK , ISA 0 MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE BANKCARD NUMBER: AUTHORIZED SIGNATURE: " 1 �' �, r co � y 5t{ 0 0 gg 1 a a ff 6 C � as �„ rn O rfl I— X 111 r hts site Plan is being obtaining sub repres a buildin milted for W s/dentation °/ the ermlt and is a true and pufPOse of t1t line bore beennsa s cu ntitie.bl n s st u Att knowq pfo°freot ii pro dies IP • of wat:.; t:.• s so in��atetl and e easements y D Signed: l �/�+./ 7rGN • ,other wetlands, m O08 t u+ n Date: _�. i critical areas .5. 21.21.Z01, O z rn• r � ovm } T.9 aux N— t�, t� �••�• Ur>i • N Q31. rntl c ei r/r . r --� r odd: • I ? f rN _ a � �,. 1.1- 1.• omr- _ ` ,....:,,(,),. 'wii wit III 1 I '' lora/ V41. . o. �c ).1110>2 4 T(---,- )--- . .. . In 0 IP r IIIIIIIIIIIIIIII IV 1 � • • • r 1411,- r I I. d 0 '13 attfl -nj -11i ( i-N 4 711, Z •