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2004, 11-08 Permit Application: 040009031 Duplex W/Garagesn j� a - '31 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)680036 Fax: (509)688 -0037 REQUIRED SITE INFORMATION STREET ADDRESS: 2— / L /Y L /47 VI-- ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: '5/53./9zz PERMIT DESCRIPTION: �. pkx ®BUILDING PERMIT RELOCATION C� CHANGE IN USE O GRADING C] MANUFACTURED HOME O SIGN Q- TENANT �}OFlER OWNER / APPLICANT INFORMATION a OWNER: ,z 231( (I(, ?/2I&7 PHONE: (509122 53 ' FAX: ADDRESS: 26t'206 SA45Oi7 .9ye .-i/fii71/2/1 /wee ® h., q9 0 2 5 CITY,STATE, ZIP CONTRACTOR: PHONE: FAX: ADDRESS: CITY, . STATE, ZIP WA ST CONTRACTOR LICENSE # D APPLICANT: k' PHONE: FAX: ADDRESS: CITY, STATE, ZIP Q ARCHITECT: PHONE: FAX: ADDRESS: CITY, STATE, ZIP CONTACT: PERMIT /BUILDING INFORMATION COST OF PROJECT: 1/20, 000, BUILDING HEIGHT TO PEAK:�.,(1 �Q / BUILDING DIMENSIONS: &i X et316 NUMBER OF STORIES: g NUMBER of BEDROOMS: 6 FLANKING SETBACK: FRONT SETBACK: REAR SETBACK: LEFT SETBACK: 2 f/ /o(- 7'1 30% SLOPES ON PROPERTY: .4/0 OCCUPANCY GROUP: CONSTRUCTION TYPE: 3 STRUCTURES ON PROPERTY: I CRITICAL AREAS: /✓D CURRENT PROPERTY SIZE: 6 1. j 3?5-' CURRENT PROPERTY USE: V '3, $ CURRENT SEPTIC USE: $ 2 Lt/ CURRENT WELL USE: C If y RIGHT SETBACK: / ( i f f/ 1 �}Y 9 IMPERVIOUS SURFACE AREA: 9 7 Q Ceirk MAIN FLOOR SQ FT: t 53,Sf 2N0 FLOOR SQ FT: (e53/ S UNFIN BASEMENT: /1/© FINISHED BASEMENT: 47-2 GARAGE: 5512 . F COVERED DECK: DECK: WA STATE NON - RESIDENTIAL ENERGY CODE MANUFACTURED HOME SIGN WIDTH: YEAR: MANUFACTURER: LENGTH: PIT SET: SQ FT OF SIGN: # OF SIGNS: TYPE OF SIGN: HEIGHT OF SIGN: AREA OF EXIST SIGN: RELOCATION FIRE SAFETY i PREVIOUS ADDRESS: PROPOSED USE: FIRE SPRINKLER: PAINT BOOTH: FIREWORKS DISPLAY: BLASTING: FIRE ALARM: TENT: DATE/TIME: PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS ® BOLTING FIRM NAME: iNSPECTOR(S): °CONCRETE ® REINFORCEMENT PHONE: ® WELDING FAX: BUILDING STAFF USE ONLY 1 IS PUBLIC SEWER AVAILABLE: D YES D NO D D IS PUBLIC WATER AVAILABLE: YES NO IF YES: COUNTY ® CITY IF YES, WHICH WATER DIST /IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: D YES ® NO PSSA: 0 YES 0 NO DATE: 1 METHOD OF PAYMENT: 0 0 STAFF: CASH CHECK 0 VISA BANKCARD # EXPIRES.' VIN # AUTHORIZED SIGNATURE :: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD Sfiolane „FA/alley Project Address: Owner: Maiiing Address: s ti PLUMBING PERMIT APPLICATION City of Spokane Valley Community Devefopment Department BuifdingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-003S; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688 -0054 Permit Use: • Phone (Daytime Contact): City State Zip Code Contractor: License #: Phone #: Mailing Address: City State Zip Code DATE: EXPIRES: BANKCARD NUMBER_ TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK *OF . - UNITS X TOTAL COST AMOUNT t TOILETS WATER CLOSET, BIDETS 4 X $6.00 = 2 URINALS 0 X $6.00 = 3 TUBS If 7. X $6.00 4 SHOWERS (PE R TRAP) BATH, STALL, ONSrI = BUILT j 0 X _ E $6.00 5 SINKS LAVS1BASINS, BAR, FLOOR, 6 KITCHEN, LAUNDRY, UTILITY, X JANITOR, PHOTO, X -RAY, FOOD. PREP /CULINARY/MEAT - $6.00 6 DISHWASHER 2 X $6.00 7 CLOTHES WASHER X $6.00 = 6 GARBAGE DISPOSAL 2 X $6.00 = , 9 WATER SOFTENER Q X $6 -00 = { 10 ELECTRIC HOT WATER TANK NOTE IF GAS, SEE MECHANICAL X $5.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH,. ,: X CONDENSATE $6.00 � 12 I � ROOF DRAINS(OVERFLOW DRAINS I i 10 X c t 65 .00 I= I ' 13 FOUNTAINS, DRINKING V X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, 0 . X REPAIR, REVERSALS $6.00 15 SEWAGE EJECTOR 0 ' GRINDER SUMP PUMP 0 X $6.00 = ` 16 WATER USING DEVICE ICE AN /OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, ii CARBONATOR, SWAMP COOLER X $6.00 = ` 17 F CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, ANORP.B.P.D. FOffi X WOO a VATS, TANKS, BOILERS 0 18 INTERCEPTORS - GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK Q X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN V X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE C X $6.00 = • METHOD OF PAYMENT: ❑ CASH 0 CHECK ❑ VISA 0 MASTERCARD SUBTOTAL PROCESSING FEE _ $35.00 DATE: EXPIRES: BANKCARD NUMBER_ TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: SO1an .000Valley MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite- 106 Spokane Valley, WA 99206 Phone: (509) 688 -0036; Fax: (509) 688 -0037 FOR INSPECTIONS, CALL (509) 688 -0054 Project Address: Permit Use: Owner. Phone (Daytime Contact): ••Maitiri Address: Contractor: Mailing Address: City License #: Phone #: State . Zip Code DESCRIPTION OF WORK ` # OF UNITS ' X • COST a TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $45.00 = --FUE#-BURNINGAPPL1ANCE More than-100,000 X $19.00 = 3 UNLISTEDAPPLIANCE (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 5 rating) Equal to or less than 400,000 / X $50.00 ' USED APPLIANCE (WSEC min. AFUE 5 rating) More than 400,000 X 5100.00 - 7 B©LLER/REFRIGERATION 1 -100M BTU • _ X $15.00 = BORER/REFRIGERATION 101 - 500M BTU X $28.00 9 BO[LER/REFRIGERATION 501 - 1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU . X .00 557.00 = 11 BOtLERIREFRIGERAFIONt More than 1,750M BTU X $95.00 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $10.00 = 13 RANGE X $10.00 = 14 DRYER X $10.00 = 15 , FUEL BURNING WATER HEATER X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10,00 = 17 • GAS PIPING (each outlet) X 51.00 1 18 DUCT SYSTEMS X $1009 • 19 VENTILATING FANS X $10.00 = 20 AIR HANDLER (DOES NOT include ducting) Equal to or less than 10,000 CFM X ( L $12.00 = 21 AIR HANDLER(DQES NOT include ducting) Greater than 10,000 CFM X 519.00 = ` 22 EVAPORATIVE COOLERS _ X $10.00 23 TYPE I HOOD X $50.00 = 24 TYPE It H000 X $10.00 = 25 HEAT PUMP /AIR CONDITIONER 03 TON X $12.00 = 26 ' AIR CONDITIONER 3 -15 TON • X ' $20.00 = • -27-AIR-CONDITIONER- CONDITIONER- - -TON r T5-3 X 525.00 = 25 AIR CONDITIONER 30 SG TON X $35.00 f 1 = 23 ' AIR CONDITIONER More than 50 TON X ' $60.00 = 30 i LPG STORAGE TANK X $10.00 = - 31 WOOD OR PELLET STOVE/INSERT X 510.00 - 32 1 WOODSTOVE- FREE STANDING X 525.00 = METHOD OF PAYMENT: 0 CASH ❑ CHECK ❑ VISA El MC CARD #: DATE: SUBTOTAL PROCESSING FEE 535.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: Zip Code Project Number: 04009031 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/08/2004 Page 1 of 3 Project Information: Permit Use: NEW DUPLEX W/ATT GARAGES & CARPORTS - Contact: CHUBENKO, NIKOLAY ELECTRIC BASEBOARD Address: 26820 E SANSON AVE C - S - Z: NEWMAN LAKE, WA 99025 Setbacks: Front 20 Left: 10 Right: 10 Rear: 240 Phone: (509) 226-5349 Group Name: Project Name: SiteInformation: . . ................ . .................. . . ......... . ........................... . ..................... .......... .....,..................... Plat Key: Name: OPPORTUNITY TR # 01-354 District: Nort Parcel Number: 45153.1922 Block: SiteAddress: 12718 E ALKI AVE Location:: CSV Zoning: UR-3.5 Urban Residential 3.5 Water District 011 MODERN Area: .00 Acres Width: 65 Depth: 325 Right Of Way (ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Lot: Owner: Name: CHUBENKO, NIKOLAY Address: 26820 E SANSON AVE NEWMAN LAKE, WA 99025 Hold: El Review Site Plan Review Plan Review Approach / Drainage TA 6 kA. lir 14,0 t_ Sewer Review ....... ..... .. .. ..... Operator: K_C Printed By: K_C Print Date: 11/08/2004 Project Number: 04009031 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/08/2004 Page 2 of 3 Contractor: OWNER Item Description APPROACH INSPECTION CONST IN ROW - APPROACH Contractor: OWNER Group: R -3 Building Height Stories Dwelling Units Type: VB 28 2 2 Approach Firm: OWNER Phone: (000) 000 -0000 Units Unit Desc 1 NUMBER OF 1 NUMBER OF Permit Total Fees: Building Permit Fee Amount $25.00 $25.00 $50.00 Firm: OWNER Phone: (000) 000 -0000 Building Characteristics Description Gtr Type Notes 2ND FLOOR R -3 VB CARPORT U -1 VB GARAGE U -1 VB RESIDENCE R -3 VB Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW Contractor: OWNER Item Description VENTILATING FANS CLOTHES DRYER HOOD -TYPE II Operator: K_C This Application: Total Project: Sq Ft Valuation Sq Ft Valuation 1,653 $123,446.04 1,653 $123,446.04 320 $4,800.00 320 $4,800.00 550 $10,450.00 550 $10,450.00 1,653 $123,446.04 1,653 $123,446.04 Totals: 4,176 $262,142.08 4,176 $262,142.08 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Permit Total Fees: Mechanical Permit Fee Amount $1,906.55 $4.50 $762.62 $2,673.67 Firm: OWNER Phone: Units Unit Desc 6 NUMBER OF 2 NUMBER OF 2 NUMBER OF Printed By: K_C Permit Total Fees: (000) 000 -0000 Fee Amount $60.00 $20.00 $20.00 $100.00 Print Date: 11/08/2004 Project Number: 04009031 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/08/2004 Page 3 of 3 Plumbing Permit Contractor: OWNER Firm: OWNER Phone: (000) 000 -0000 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 4 NUMBER OF $24.00 SINKS 6 NUMBER OF $36.00 TUBS 4 NUMBER OF $24.00 DISH WASHERS 2 NUMBER OF $12.00 GARBAGE DISPOSAL 2 NUMBER OF $12.00 CLOTHES WASHER 2 NUMBER OF $12.00 ELECTRIC HOT WATER TANK 2 NUMBER OF $12.00 FLOOR DRAINS 2 NUMBER OF $12.00 WATER USING DEVICES 4 NUMBER OF $24.00 Permit Total Fees: $168.00 Notes: ::> ......................................................................................... ............................... . Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Approach $50.00 $50.00 $0.00 $50.00 Building Permit $2,673.67 $2,673.67 $0.00 $2,673.67 Mechanical Permit $100.00 $100.00 $0.00 $100.00 Plumbing Permit $168.00 $168.00 $0.00 $168.00 $2,991.67 $2,991.67 $0.00 $2,991.67 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: 11/08/2004 1 1 ON IND 65.00 - • Qp \ 12715 E �LKf 441E P4RCEL : 45153.1922 431 -6" r —i PROPOSED DUPLEX --- r------- --r ---1 I I . I I o i I I PLANNING DEPT. APPROVE) BY. DATE: IND OM 65.00' E. A.<I AYE. SITE PLAN SCALE: 1"=20' ECEOVE OCT 2 5 2004 UadooN�