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2005, 07-27 Permit App: 05002743 ResidenceC -2-14- BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688 -0036; Fax: (509) 688 -0037 ECUIVE IJE ' Ii tit Street Address: apoe1 ik arc. Rc\ ORMATION tr t� ssaq • 7 q 51 1 Assessor's Tax Parcel Number(s): afPx\A 66 0-17, b---11(j Legal Description: fit Nal PERMIT DESCRIPTION: Plc ,Cyr` ( C (Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured HolW ❑ Tenant Improvement ❑ Fire Safety ❑ Other ❑ Relocation OWNER/APPLICANT INFORMATION Owner: V ck Phone: It ri (CtFax: Address: City ucti Contractor: Phone: Address: State c. Fax: Zip Code EV Applicant: Phone: Fax: Address: City State Zip Code ❑ Architect: Phone: Fax: Address: City State Zip Code City State WA State Contractor License #: \I 1111'Iv C iG j Contact: Spokane Valley Bus. Liscense #: Contact: Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: / �+ �� DIMENSIONS: x r # OF STORIES: l t /2 MAIN FLOOR TO SQ. FTG: /Mg eu FLOOR SQ. FTG: PtiA UNFIN BASEMENT SQ. FTG: AYA FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV PATIO SQ. FTG: OCCUPANCY GROUP: kF. . CONSTRUCTION TYPE: 66. HEAT SOURCE: # OF BEDROOMS: "1 TOTAL HABITABLE SPA E: IMPERVIOUS ,SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON -SITE SEPTIC SYSTEM? SF tJJEZ MANUFACTURED HOME Width: Manufacturer: Length: Year: Pit Set: RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Tent: Fireworks Display: Blasting: Valuation: Above /Underground Storage Tank Size: Paint Booth: Date/Time: WASHINGTON STATE NON - RESIDENTIAL ENERGY CODE Plans Examiner: Phone: Fax: Address: City State !nspector: Phone: Fax: Address: Zip City State Zip SPECIAL INSPECTIONS BOLTING fI CONCRETE Firm Name: n REINFORCEMENT Phone: Inspector(s): Fax: f WELDING 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, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit inure to the property owner. Print Name Signature . Method of Payment: (Faxed permit applications will only be a?c p ed with major bankcard)% Cash "[] Check n Mastercard, • ❑ VISA tiOther Bankcard #: ' , . �4 Expires: ,1 VIN #: II :1 ! r �*' Authorized Signature. 1 ...1 \Talley Project Address:. ,JL.,) t L 4 f\ O () �( , Owner: \i � ',c' i ,��;', l CYNC. -rrt , �l�-Lt Mailing Address: At r. L LC) , : i, "0 s. Y\ Pk MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Var(ey, V /A, 009/14, Phone: (509) 688 -0036: Fax: (509) 688 -0037 FOR INSPECTIONS, CALL (509) 688 -0054 Permit Use: `1t`�� Phone (Daytime Contact): City t State Zip Co�d!e t_0 Phone #: Zip Code Contractor: C ��a-; t 41.��,��v � License #: Mailing Address: City State AUTHORIZED SIGNATURE: DESCRIPTION OF WORK # OF UNITS ): COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 More than 100,000 X X $15.00 $19.00 = 2 FUEL BURNING APPLIANCE 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 More than 400,000 X X $50.00 5100.00 = 4 UNLISTED APPLIANCE (Additional Fee) 5 USED APPLIANCE (WSEC min. AFUE rating) Equaf to or less than 400,000 More than 400,000 X X $50.00 $100.00 = 6 USED APPLIANCE (WSEC min. AFUE 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 BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION 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 1 X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 17 GAS PIPING (each outlet) X $1.00 = 18 DUCT SYSTEMS X $10.00 = 19 VENTILATING FANS t" X $10.00 = 20 AIR HANDLER (DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER (DOES NOT include ducting) Greater than 10,000 CFM X $19.00 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD j X $10.00 = 25 HEAT PUMP /AIR CONDITIONER 0 -3 TON 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 STOVE/INSEP.T X 510.00 = 32 WOOD STOVE - FREE STANDING X 525.00 = METHOD OF PAYMENT: ❑ CASH ❑ CHECK ❑ VISA ❑ MC CARD #: DATE: SUBTOTAL PROCESSING FEE 535.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: S�kane -0 Miiiey Project Address: ace 1,._\ n(c_ Owner:�F��(�'h`i Mailing Address: - >sc`j t�� L ,.; tom y' Contractor: ...3 I r' yi� Mailing Address: S . . PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 111707 E. Sprague Avenue, Suite 106 Spokane 'vaiicy, VVA 9920f. Phone: (509) 688 -0036; Fax: (509) 688 -0037 FOR INSPECTION'S, CALL (509) 688 -0054 Permit Use: r r �, Phone (Daytime Contact):kr - -1VF: - 9 / U .. `,!!ky'y •\ City State Zip Code License #: C\ f6)1✓Phone #: —C 1z�� 13 City — _ State Zip Code BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 0( X $6.00 = 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON -SITE BUILT X 56.00 = 5 SINKS LAVS /BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X -RAY, FOOD, ) X $6.00 = PREP /CULINARY/MEAT 6 DISHWASHER X 56.00 = 7 CLOTHES WASHER I X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS /OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = 14 WATER PIPING /DRAIN -IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 56.00 = 16 WATER USING DEVICE ICE AN /OR 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: VATS, TANKS, BOILERS X 56.00 = 15 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: ❑ CASH ❑ CHECK DATE: ❑ VISA ❑ MASTERCARD EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: 000'Nkm... Spo'liane 4,01.0\0ey Call 24 hours before inspection required Phone 509.658 -0036 Fax 509.688 -0037 DEPARTMENT OF PUBLIC WORKS Anticipated start date APPLICATION Location of property Applicant Name Permit # PW APPROACH PERMIT ddress /Parcal #, if available) r r R Contractor's Name +i Contractor's Reg# \I� Expires s tap, rt)(i) PROJECT DESCRIPTION (Provide site sketch) Residential Driveway Existing Curb & Gutter 1-1 Culvert Installation Other conditions 11 Commercial/Industrial Driveway Rural Road Section 1 Sidewalk Repair /Cortstruction See construction requirements and details on reverse. Bond/insurance certification must be on file with thee'Cii . s 14, imok. SPECIAL CONDITIONS: PERMIT FEE $ Ins » action Fee$ I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Card # Name of Holder Fees Paid$ Expiration Date SI• nature Date Init ** TOTAL PA5E.05 ** Project Number: 05002743 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/10/2005 Page 1 of 4 Project Information: Permit Use: NEW RESIDENCE W /ATTACHED GARAGE -GAS Setbacks: Front 33 Left: 7 Right: 6 Rear: 28 Site Information: Contact: VIKING CONSTRUCTION INC Address: 2605 W HAYDEN C - S - Z: HAYDEN LAKE, ID 83835 Phone: (208) 762 -9106 Group Name: Project Name: ROW Plat Key: Name: Hidden Valley District: East Parcel Number: 55073.1951 SiteAddress: 2009 N ARC RD Location:: CSV Block: 1 Zoning: UR -3.5 Urban Residential 3.5 Water District: Area: .00 Acres Lot: 51 Owner: Name: VIKING CONSTRUCTION INC Address: 2605 W HAYDEN HAYDEN LAKE, ID 83835 Hold: ❑ Width: 68 Depth: 91 Right Of Way (ft): 38 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: c ... Review Site Plan Review Released By: Plan Review Originally Released: 08/04/2005 By: c j j anssen Released By: Approach / Drainage Originally Released: 08/01/2005 By: TMELBOU Released By: Sewer Review Permits: Originally Released: 08/04/2005 By: cjjansse Released By: Operator: CJJ Printed By: CJJ Print Date: 08/10/2005 Project Number: 05002743 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Approach Date: 08/10/2005 Page 2 of 4 Contractor: VIKING CONSTRUCTION Address: 2605 W HAYDEN AVE HAYDEN, ID 83835 Item Description APPROACH INSPECTION CONST IN ROW - APPROACH Contractor: VIKING CONSTRUCTION Address: 2605 W HAYDEN AVE HAYDEN, ID 83835 Total Area Building Height Stories Dwelling Units 1943 22 2 1 Description Grp BASEMENT F R -3 DECK R -3 GARAGE U -1 RESIDENCE R -3 Firm: VIKING CONSTRUCTION Phone: (208) 762 -9106 Units Unit Desc 1 NUMBER OF 1 NUMBER OF Fee Amount $25.00 $25.00 Permit Total Fees: $50.00 Building Permit Firm: VIKING CONSTRUCTION Phone: (208) 762 -9106 Building Characteristics Type Notes VB VB VB VB Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW This Application: Sq Ft Valuation 929 $18,580.00 96 $1,440.00 484 $18,817.92 1,014 $75,725.52 Totals: 2,523 $114,563.44 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Operator: CJJ Printed By: CJJ Permit Total Fees: Print Date: Total Project: Sq Ft Valuation 929 $18,580.00 96 $1,440.00 484 $18,817.92 1,014 $75,725.52 2,523 $114,563.44 Fee Amount $1,077.75 $4.50 $431.10 $1,513.35 08/10/2005 Project Number: 05002793 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/10/2005 Page 3 of 4 Contractor: FITTING MECHANICAL Address: 10223 HAPPY TRAIL RATHDRUM, ID 83858 Item Description GAS WATER HEATER GAS APPLIANCE <= 100,000BTU GAS PIPING VENTILATING FANS CLOTHES DRYER RANGE HOOD -TYPE II Contractor: BELKNAP PLUMBING Address: 3414 S ADAMS RD VERADALE, WA 99037 Item Description TOILETS/BIDETS SINKS TUBS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER WATER USING DEVICES Mechanical Permit Finn: FITTING MECHANICAL Phone: (208) 687 -6949 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 3 # OF UNITS 4 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF Permit Total Fees: Plumbing Permit Fee Amount $10.00 $12.00 $3.00 $40.00 $10.00 $10.00 $10.00 $95.00 Finn: BELKNAP PLUMBING Phone: (509) 921 -5913 Units Unit Desc 2 NUMBER OF 3 NUMBER OF 2 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 3 NUMBER OF Fee Amount $12.00 $18.00 $12.00 $6.00 $6.00 $6.00 $18.00 Permit Total Fees: $78.00 Operator: CJJ Printed By: CJJ Print Date: 08/10/2005 Project Number: 05002743 Notes: Inv: 1 Application Date: 08/10/2005 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary: Permit Type Approach Building Permit Mechanical Permit Plumbing Permit Fee Amount $50.00 $1,513.35 $95.00 $78.00 Invoice Amount $50.00 $1,513.35 $95.00 $78.00 $1,736.35 $1,736.35 Amount Paid $0.00 $0.00 $0.00 $0.00 Amount Owing $50.00 $1,513.35 $95.00 $78.00 $0.00 $1,736.35 Page 4 of 4 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: CJJ Printed By: CJJ Print Date: 08/10/2005