2002, 07-09 Permit App: 02005678 Residence Project Number: 02005678 Inv: 1 Application Date: 7/9/02 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-GAS Contact: HARLEY C DOUGLASS INC
Address: 8510 N CRESTLINE ST
C- S-Z: SPOKANE,WA 99217-
Setbacks: Front 34 Left: 10 Right: 20 Rear: Phone: (509)487-9792
Group Name:
Site Information: Project Name:
Plat Key: 006093 Name: RIDGEMONT ESTATES NO.4-7TH ADD District: F
Parcel Number: 45252.5207 Block: 1 Lot: 7
SiteAddress: 15511 E 21ST CRT Owner: Name: HARLEY C DOUGLASS INC
VERADALE, WA USA 99037 Addiess: 8510 N CRESTLINE ST
Location::VER SPOKANE,WA 99217-
Zoning: UR-3.5 Urban Residential 3.5
Water District: 010 VERA Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
R ---- -.
Site Plan Review
Released B
Plan Review Released By: � —1/1)/0-Z-
-
Approach/Drainage Released By: 0,24)
--.- _ �
0 s0,38Y0
Sewer Review / C__L-1 A.) Released By:
9')
Permits:
Operator: JAS Printed By: JAS Print Date: 7/9/02
Project Number: 02005678 Inv: 1 Application Date: 7/9/02 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: HARLEY C DOUGLASS INC Firm: HARLEY C DOUGLASS INC
Address: 8510 N CRESTLINE Phone: (509)487-9792
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: x Building Sq Ft: 2260 Sprinklers: El
Req Parking: Handicap Parking: Critical Materials:
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VN 902 $11,094.60 902 $11,094.60
DECK R-3 VN 120 $939.60 120 $939.60
GARAGE U-1 VN 506 $6,072.00 506 $6,072.00
RESIDENCE R-3 VN 1,358 $89,628.00 1,358 $89,628.00
Totals: 2,886 $107,734.20 2,886 $107,734.20
Item Description Units Unit Desc Fee Amount
RESIDENTIAL VALUATION 1 Y OR BLANK $935.00
STATE SURCHARGE 1 Y OR BLANK $4.50
RESIDENTIAL SURCHARGE 1 Y OR BLANK $205.70
Permit Total Fees: $1,145.20
Mechanical Permit
Contractor: COMPLETE HEATING&SHEET Firm: COMPLETE HEATING&SHEET
Address: PO BOX 3934 Phone: (509)533-9528
SPOKANE.WA 99220
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 3 NUMBER OF $30.00
CLOTHES DRYER 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
Permit Total Fees: $75.00
Operator: JAS Printed By: JAS Print Date: 7/9/02
r
Project Number: 02005678 Inv: 1 Application Date: 7/9/02 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 2 NUMBER OF $12.00
SINKS 2 NUMBER OF $12.00
SHOWERS 2 NUMBER OF $12.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 3 NUMBER OF $18.00
CLOTHES WASHER 1 NUMBER OF $6.00
WATER USING DEVICES 2 NUMBER OF $12.00
Permit Total Fees: $84.00
Notes:
Payment Summary: :.,gin.
Peuuit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,145.20 $1,145.20 $0.00 $1,145.20
Mechanical Permit $75.00 $75.00 $0.00 $75.00
Plumbing Permit $84.00 $84.00 $0.00 $84.00
$1,304.20 $1,304.20 $0.00 $1,304.20
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: JAS Printed By: JAS Print Date: 7/9/02
II HI _I‘../I-1 I ILiI 4 5V Li I tt''-►s ii....L.. I
General Information i
��7o aidress 1 r G.T. Pareclnumber I
. 155 a , ; lso'
Phone 1
Owner
Harley C. Douglass Inc. 509-487-9792
-milling address
815 E. Rosewood
-City Slate Zip
Spokane Washington 99208
tSite Information y
Legal Desenpliont
1—.÷ _7_ 6 Lk I Rdg ,>4. gs-i-j-es #60/.- lit la'kid;fid,L
i'i iiysize Water Unita NumberlJ eU gr Budd ger
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:;;.�L•ti, r Y v{ ¢ 1 . 2. r N. $ "...>1.5!:s4 . r..ti t� ${ i i•
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��:3'R4- . r. , y �l v'Y+O:' �.,v^,... �t``:X � rx > '
LProject Information I.
Permit Use New Addition Remodel Change Muse
Building Information i •
Dwelling units Occupant load Budding height Stones
Building dimensions • 'total square loolage Req'dparlung Handicap parking Spnollersystem `enticalMaterul
Square footage breakdown 1 Hating and insuladon Information (R—valnes) t
X358 Uncovered/coveredd h Heat source
Second tl or Other 1lll[s�O Flat ceililin/�ngI`� Vaulted ceiling Above_aradewall
l•muhedbaseement Below�gradewall Floor Slab on grade
_0 _. —C) — a �
Untinsshed basement Door(u–value) Wm ow Furnace elticency
tiara geS
o� lolat window arca %of floor arca
51:1
Contractor Information y
IJnilding contractor Plumbing contractor
Harley C. Douglass Inc. Gold Seal Mech
License number Phone License number i Phone
HARLECD110PE 509-487-9792 GOLDSM 290C4 509-924-3423
Mailing address Mailing address
815 E. Rosewood 5524 E Boone
City.slate.zip City.slate,zip
Spokane Washington 99208 Spokane Waliiiingl—onn_492 2
Ilea!ingcontractor Other Lender
Complete Heating
License number Phone License number Phone
COMPLHS 066 CP 928-9876
Mailing address Mailing address
1934 Marshall
City,slate,zip City,stale,zip
Spokane Washington 99207
I_PROJECT CONTACT PHONE .
Harley C. Douglass 509-487-9792
Spokane County Division of Buildings
1026 West Broadway Ave * Spokane, Wa 99260 * (509) 456-3675
PLUMBING PERMIT APPLICATION -
OJEel'ADDRESS: L4 7 /3( C ) .::Ri- p• SYp 'et /do t h `l 7'61' 'izi.�
VNER: HARLEY C. DOUGLASS INC. PI"TONE: 509-487-9792
AILING ADDRESS: 815 EAST ROSEWOOD SPOKANE WASHINGTON 91208
(strcct) (city/state) (zip)
)NTRACTOR: GOLD SEAL MECH. LICENSE: GOLDSM 29001
EIiONE� 509-535-5944•
kILINGADDRESS: 5524 EAST BOONE SPOKANE WASHINGTON- 99Z1'Z• : _. •
I. (strcct) (city/state). (zip)
PCURIIIN(s HXI'Q`it'J #($11 to F.- 1..: .
DESCRIPTION I DOTAL UNITS WIMPY_ /UNIT lenUAIS AMOUNT,
6TOILETS WATER CLOSETS.BIDETS 2,- x $6 = $ 1Z.W
1 URINALS .x $6 = S --
14 TUBS BATIt.JACUZZI.SPA.GARDEN 2 .:: . $6 = S ILS--2-'
)5 SHOWERS(per trap) BASE,STALL,oN-SITE BUILD 2.. x $6 = S (2,(14-----
SINKS _ LAVS/BASINS.BAR.FLOOR.IIrC1ICN. 2, X $6 = $ I S c
LAUNDRY.UTILITY.JANITOR.PHOTO,.
X—RAY.POOD(PREP/CULINARY/MEATI 1 _,_
)7 DISHWASHER -
58 CLOTHE WASHER _ - x S6 ._ S --
Q sARBAGE DISPOSAL/GRINDER - x $6 = $
1.,WATER SOFTENER x _. $6 = $
11 ELECTRIC HOT WATER TANICS MOTE: Lf gas water task.aca.ccha.Igt) _ x $6 = S.
'(2 FLOOR DRAINS - AREA.CASE.COIL.TRENCH,CONDENSATE , x $6 = S
.t3 ROOF DRAINS/OVERFLOW DRAINS(ca.) - x $6 _ = $
0 FOUNTAINS,DRINKING - x $6 = $
15 WATER PIPING/DRAIN-WASTE-VENT INSrAIIATION.ALTERATION OR REPAIR x S6 = $
•
!i l'6 SEWAGE EJECTORS GRINDER,sump PUMP . x S6 = S.
3X7 WATER USING DEVICES ICE AND/OR COFFEE MAUR. x $6 = $
> > NOSE BIB.STUAMER.PROOPER.
CARBONATOR,SWAMP COOLERS
318 CROSS—CONNECTION DEVICES VACUUM BREAKER.CHEM VALVE. .. $6 = $
AND R.P.B.P:D.POR:VATS.SUMPS. '
Fs :... . TANKS,BOILERS.&SPRINKLER SYSTEMS
40 INTERCEPTORS OREASETRAP.SANDTRAP, X $6 = $.
. ._ CIIEMICAL HOLDING TANK
a MEDICAL GAS(per outlet/bottle station) Nrraous.oXYGEN x. $6 = $
—
B iI MISCELLANEOUS • x. _ $6_ = $ • Guo
Subtotal (a6 u°
_NOTE: MINIMUM PERMIT FEE IS $35.00 PLUS: PROCESSING PEE $25.00
TOTALPER . I?EE DUE $
SIGNATURE: (� 9SPOLCAM COUNTY D[VISION'OF BUILDINGS
WIIST 1026 BROADWAY AVIINUII'SCGKANL'.WA 99260•(509)356-3675 S)(a
3.CT-IAl4ITOAL'•1CR vuIT APPLI ATION
PROlECFADDRESS: Li- / /JLN. 1 KI cla i,,, . „ ,:..s.. . ..,-. ...---4 / / cL . Pt i de e IQ jti
OWNER: HARLEY C. DOUGLASS INC. ,PHONE: 5I9-487-9781
MAILING ADDRESS: 815 EAST ROSEWOOD SPOKANF WASHINGTON 9(1211R
(street) (city/state)- (ziP)
CONTRACFOR: COMPLETE HEATING & SIiEETAAETAL LICENSE: COMPi Nsnfia.-p
PHONE:
MAILING ADDRESS: t 14 1 : ' • . _ , - . I. • . •
(street) ... (citylstatc) (zip)
I_ . .. . . .. ,.,ten_ r0J -----_
DP5CRWrTOH OF WORK OF Ian. _run; LIMIT AMOUNT
1302' FUEL BURNING APPLIANCE
a or<loo,000 - l' . £12 — ,• 1•2.;114.
1303 FUEL BURNING APPLIANCE >too,000 $15 - ,.
I3.44 UNLISTED FUEL BURNING APPLIANCE •_.. .. a or<too,00w ; •- .
BOS UNLISTED FUEL BURNING APPLIANCE >400.000 $100 _ I, —
1106 USED APPLIANCE(Must meet WSECs min.AFUE rating) ..or<400,9oo SSO _ ,
13Qy USED-APPLIANCE(Must mc_t WSECs min.AFUE rating) •>400,000 $100 _ ,
lia BOILER/REFRIGF_RATION t-toots aru $12 _ ,
J
1309 BOILER/REFRIGERATION BTU tot—so0M a . $20 - ,
1310 BOILER/REFRIGERATION 501—t.000M BTU . - $25 - , --
13, BOILER/REFRIGERATION Loot-1,750M BTU $35 - r. --
c`—
I312BOILER/REFRIGERATION +1.750M uni . $60 -. , —
iiiiii GAS LOG,GAS INSERT,AND/OR GAS FIREPLACE - $10 - , 10.42-
B 14
c uLB14` RANGE - • $10 ,
T31'5 DRYER - • $10 _
---
Bre FUEL BURNING WATER HEATER - $10 _ , 10 uo
•
Ba: MISCELLANEOUS FUEL BURNING APPLIANCE - . $10 _ ,
1318 GAS PIPING(ca.outlet) - $1 - , 40o
B19. DUCT SYSTEMS - , . $10 _ , lkIv?
.i3�Q, VENTILATING FANS ' - $10 - , 3v st-
1321: AIR HANDL FR(DOES NOT indudc duct systems) • ..or<10,000 CPM $12 - ,
1322 AIR HANDLER(DOES NOT include duct systems) >to,000 CM $15 - ,
1123 EVAPORATIVE COOLERS - $10 - ,
B4': TYPE I HOOD - . $S0 ,.
1325 TYPE II HOOD - , $10 - ,
I32& HEAT PUMP/AIR CONDITIONER o-5 TOUT £12 - ,
B27 AIR CONDITIONER 6—ISTONS $20 _ , _
1328' AIR CONDITIONER t6-3oTONs . $25 - ,
iii0.:i AIR CONDITIONER 31-SOTONs $35 _ , . ..
B30 AIR CONDITIONER +SOTONS $60 _ ,
bil LPG STORAGE TANK - .. . $10• :.- ,_ ' -
1)3 : WOOI7)OR PEfLrT STOVE/INSrR..' $25 -
.. _Subtotal Ott.
NOTE: MINIMUM PERMIT'FEE IS S3500 , PLUS: PROCESSING FEE $25.0
_ -j.
TOTAL PERMIT FEE DUE. ' S (3.02
SIGNATURE: . /if \ ` •
•
SP.OKANE.COUINTY DIVISION OP BUILDINGS
WEST 1026 BROADWAY AVT:NUP 'SPOKANE..WA 99260 -(509) 456-3675
JAN-26-2002 18:53 FROM:TAS-PDS-PCS 5093254587 TO:6890037 P:2'3
TAS Technical Assistance Services
Garden Court Building.222 W Mission Avenue, Suite 235,Spokane,WA 99201 (509)325.4476 FAX(509)325-4587
10/24/03
City of Spokane Valley
Building Department
Attn: Dawn Dompier
11707 E. Sprague Ave. #106
Spokane Valley, WA
Project: Single Family Residence
Total Area: 2246 sq.ft.
Glazing Percentage: 10t
Address: Peterson Residence
15511 E. 21st Court
City of Spokane Valley
Contractor/Phone:
Heating Type: Gas
PROJECT COMPLIES with TABLE 5-1/ TARGET COMPONENT VALUES FOR
GROUP R OCCUPANCY, 2000 Washington State Energy Code--07/01/02
Amendments.
ALLOWABLE HEAT LOSS (Btu/h/deg.F)
Glazing: 15* 2246 cg.ft. • 336 .9 @ U .40 • = 134 .8
Doors: 40 sq.ft. @ U .20 = 8 .0
Ceiling (Attic) : 1351 sq. ft. U .031 = 41 .9
Walls (1845 gross sq.ft. ) : 1468 sq.ft. R19 @ .062 = 91.0
Floor: 428 sq.ft. R30 @ U .029 = 12 .4
Slab: 35 l .f. R10 vert F-value .54 = 18.9
BG Walls: (7' depth) : 554 sq.ft . ® U .037 = 20.5
75 1 .f. ® .57 F-value = 42 .8
(4' depth) : 110 sq.ft. @ U .041 = 4.5
27 .5 1.f. @ .64 F-value = 17.6
TOTAL UA ALLOWABLE = 392 .4
OCT 21 2003 14:46 5093254587 PRGE.02
JAN-26-2002 18:53 FROM:TAS-PDS-PCS 5093254587 TO:6880037 P:3'3
PROPOSED HEAT LOSS (Btu/h/deg.F)
Glazing (10a) : 190.0 sq.ft. Vinyl @ U .50* = 95 .0
35 sq.ft. Vinyl Patio @ U .50* = 17 .5
Doors: 40 sq.ft. insul @ U .17 = 6.8
Ceiling: 887 sq.ft. R38 6 :12 STD @ .029 = 25.7
464 sq.ft. R38 6:12/3 :12 Scissor @ U .031 14.4
Walls: 360 sq.ft. R19 INT horiz siding @ U .058 = 20 .9
1220 sq.ft. R19 INT T1-11 @ U .061 = 74.4
Floor: 428 sq.ft. R30 @ U .029 = 12.4
Slab: 35 l.f. no insulation @ .73 F-value = 25.6
BG Walls (7' depth) : 554 sq.ft. R13 @ U .050 = 27.7
75 1 . f. @ .56 F-value = 42 .0
(4' depth) : 110 sq.ft. R13 @ U .057 = 6.3
27.5 1.f. @ .63 F-value = 17 .3
*Window Products NFRC values
NOTES:
1. It is not known if the glazing has low-E so standard vinyl
U-factors were used.
2 . No slab insulation was shown because it is unknown whether
any slab an grade insulation was used.
TOTAL PROPOSED HEAT LOSS = 386.0
386.0 Btu/h < 392 .4 Btu/h -- Project complies w/ Table 5.1
Edward R. Fi
Technical Assistance Services
Dawn,
These component calculations are based on a copy of the plans and
existing construction components given to me by the owner. I did
a complete take off to determine if R13 below grade wall insula-
tion would comply with current code (2001) ; it will comply.
OCT 21 2003 14:46 509325458? PAGE.03
JAN-26-2002 18:53 FROM:TAS-PDS-PCS 5093254587 TO:6980037 P:1"3
TASTunical Assistance Services 222 W,Nficsion Ave_, Spokane, WA 99201
Phone Number 509-325-4476 Fax Number 509-325-4587
/D/ /o3
Eroxn: >� '
To:
Company: e i 'D /. /.�, j .734°,/ , , r
etc: 1V5,bS5 P1/•!/S, F ragcu
(Includes Cover)
Z3W4t4(/
-as?"ii vs J&'7 1
/3 /,J5r/4007JW. , /,ice ,-7;,4 P/7-1/7 /z-..4 /5
F i -50/L/ ?' /-
,46/1,4Z-7-51 fi T we5 Stir 7 ,k ' 45 Not 1,i
/4.-
/-3y "riiiX48 /7 'y5 Ox/,4-6y5 Ge4s
�7J 5 , /y 'av v /w47/4rr /710 5
p N r~ o -r '-rr2 r , oN yov =c �Ute_
�.afvs� P Pi ice - n Oi M/&51-
,� , 77x7
r/
OCT 21 2003 14:46 5093254587 PAGE.01
Sent By: HARLEY C DOUGLASS; 5094871580; Oct-23-03 10:15AM; Page 2
.
WATTSUN 5.5 1994 WAATE ENERGY CODE COMPLIANCE R BORT
FILE: C:\\WATTSUNS\\HD12S8SPLIT.WS HOUSE ID: H DOUGALSS 1258 SPLIT
Site: Lt 7 Blk 1 Ridgemont Estates North 0 7`"Addition Analyst: TAS
/5511 1 < 1 Vit' - - Jurisdiction: Spokane County
ti`r�6 '�"� Utility: AVLSTA
Homeowner: House Type: Single Family
Floor Area: 2313 ft2
Builder: Harley Douglass Weather Data: Spokane, WA
Climate Zone: 2
(509)487-9792
The PROPOSED design * COMPLIES* with 1994 WA State Energy Code.
REFERENCE PROPOSED
COMPONENT PERFORMANCE 449 432 Btu/hr-F
ENERGY BUDGET 9.76 9.32 kwh/ft2-yr
REFERENCE DESIGN Reference
Component Value X Area = UA
BG Wall 3.5 U-0.041 382 15.7
BG Slab 3.5 F-0.640 109ft 69.8
On Grade Slab U-0.540 3511 18.9
Floor U-0.029 435 12.6
Glazing @ 15% U-0.600 347.0 208.2
Doors U-0.390 40.0 15.6
AG Wall U-0.062 1068 66.2
Ceiling, Attic U-0.031 1367 42.4
Infiltration ACH-0.350 17400ft (105.4)
Reference UA 449
PROPOSED DESIGN COMPONENTS
Component Description Value X Area = UA
BG Wall RO Uninsulated 3.5"depth U-0.278 382 106.2
BG Slab F-0.530 109ft 57.8
On Grade Slab RO Unisulated F-0.730 35ft 25.6
Floor R30 vented Joist 160c U-0.029 435 12.6
Items in parentheses not included in COMPONENT PERFORMANCE totals.
**Denotes non-standard values --check calculation of thermal value.
--- --- -- �-N-- Page 1,-. ---- -- --
OCT 20 2003 10:59 5094871580 PAGE.02
Sent By: HARLEY C DOUGLASS; 5094871580; Oct-23-03 10:16AM; Page 3/4
. ti
' ATTSUN 5.5 1994 W,_/ATE ENERGY CODE COMPLIANCE 1 ,,ORT
FILE: C:\\WATTSUNS\\HD1258SPLIT.WS HOUSE ID: H DOUGAT.SS 1258 SPLIT
Glazing @ 11% ** 2 gl Vinyl. w/low-E U-0.400 2143 85.8
** 2 gl SGD w/vinyl Frame U-0.500 35.0 17.5
Doors 2g1 Full Lite Ins Cir U-0.360 35.0 7.6
**Metal I%",urethane flush U-0.100 19.0 1.9
**Metal I%"urethane panel U-0.140 21.0 2.9
AG Wall R19 INT Lap Wood U-0.058 1695 98.3
Ceiling **R38 6:12 STD U-0.029 1428 41.4
infiltration Standard Air Sealing ACH-0.350 18222ft3 (110.3)
Proposed UA 432
Struc Mass Light Ftame. Sheetrock walls H- 3.000 1358 4074
**SLAB NO COVER EXT. CONC.WALLS H-10.000 955 9550
HEATING/COOLING/VENTILATION SYSTEMS
PROPOSED
Heating System Type: Gas Furnace
Make: Unknown/
Model: Unkown/
System Efficiency: 83%
Modified Efficiency: 78%
Design ACl3: 0.60
Design Load(at 66F dt): 41597 Btu/hr
Duct Losses(%Dan Load): 0 Btu/hr(0%)
Total Load: 41597 Btu/hr
System Size: 62500 Btu.hr(150%)
Average Annual Heat: 96 MBtu
Annual Cost: $ 550
Ventilation System: Integrated spot
&Whole Housr
Cooling System: NONE
SEER: 0.0 (Unducted)
Cooling Load(at 12f dt): Btuhbr
System Size(%Over): tons(@125%)
Annual Cool Requirement: KWh/yr
Solar Access: Partially Shaded
PROPOSED DUCT SYSTEM
Location Ave Rvalue Surface Area
SUPPLY All in heated space
RETURN All in heated space
_— — --- Page 2— -- .......... ..._____ __
OCT 20 2003 11:00 5094871580 PAGE.03
Sent By: HARLEY C DOUGLASS; 5094871580; Oct-23-03 10:16AM; Page 4/4
v ATTSUN 5.5 1994 W‘,...;ATE ENERGY CODE COMPLIANCE IdORT
FILE: C:\\WATTSUNS\\HD1258SPLIT.WD HOUSE ID: 1-1 DOUGALSS 1258 SPLIT
GLAZING ORIENTATION
PROPOSED PROPOSED
South ft2 North 12.0ft2
Southeast : Northwest .
East : 120.5 West : 117M
Northeast : Southwest :
Eff 5 Glz: 2.8%
Economic and energy consumption estimates are designed for comparative purposes only. Actual cost for heating will
vary depending on weather conditions, occupant lifestyle and other factor.
-- ---- — —Page 3 ..---_-
OCT 20 2003 11:00 5094871580 PAGE.04
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This site plan is being submitted for thepurpose of
obtaining a building permit and is a true and correct
representation o the proposal.All known property
linesldimensio urb lines.structures and easements
have been ide Also insioatedr arer wetlands,
areas.
bodies of wate , ep s
Signed: ' -1111r
Date: