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2003, 06-02 Permit App: 03-241 Residence W/GarageCity of SPOKANE VALLEY RECE \WE JUN 0 2 2003F ID El PERMIT # BUILDING PERMIT APPLICATION 0 D Box 1 OWNER JOB LOCATION OWNER'S ADDRESS CITY PHONE DESCRIBE JOB D� THIS PROPERTY IS OWNED BY: SINGLE /MARRIED PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME 1.-E- G & k PHONE Q' Zi irq 6 y Zi —7o t1 ,le CONTRACTOR'S ADDRESS / T3 Z t g CITY CONTRACTOR'S REG.# DA. e"''e v ? C. EXPIRATION DATE ;`ter 7c- (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT ADDRESS CITY PHONE ?t 7 S E ( y ZIP BOX 4 SEWER AVAILABILITY WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST $ 6_.S CV EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR 3`a 2ND FLOOR 3RD FLOOR / OTHER BASEMENT FINISHED / BASEMENT UNFINISHED / DECK /:5":-.75 / GARAGE 3 CARPORT / TOTAL J3i( / HEIGHT TO PEAK OF BUILDING FT. BOX 8 ( ) SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT (- ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY IMPERVIOUS SURFACE SQ. FT. SQ. FT. BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. BOX 10 Water Service meter size (if known) Also see BOX 4 BOX 11 Septic Tank — Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO ERFORM THE 0 -K FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT v DATE -S (OVER) I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercard Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL REMARKS DISAPPROVAL DATE PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE TYPE OF JOB: NEW RESIDENCE RES. ADD /ALT NEW INDUSTRIAL IND. ADD /ALT NEW COMMERCIAL COMM. ALT /ADD NEW MULTIFAMILY NO. UNITS MULTIFAMILY ADD /ALT TENANT IMP. ROOF OTHER OCCUPANCY TYPE OF CONSTRUCTION STORIES BUILDING SQ. FT. @ = BUILDING SQ. FT. © = BUILDING SQ. FT. © = BUILDING SQ. FT. @ = TOTAL SQ. FT. TOTAL VALUATION BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY ASSIGNED ADDRESS Received DATE 1mrrr )pominu. 11707 E. SPRAGUE, STE 106 VaI]ey SPOKANE VALLEY, WA 99206 (509)688-0036 FAX (509)688 -0037 SITE INFORMATION PROJECT TRANSMITTAL: TRANSMITTAL DA'1'E: PERMIT INFORMATION Site Address: Co Parcel Number: Subdivision: r . -. A r+ + le,S Block: Lot: Zoning: Water Dist: Owner: Address: Building Inspector: Permit Number: $pa3.2) ( Issue Date: Permit Use: Applicant: Contact: Contractor: Phone: Phone: Setbacks — Front: Left: Right: Rear: BUILDINGS: APPROVALS 6-ve,3 PLANNING: ENGINEERS: ? 7,J Q3- 30 ce FIRE ' S WATER DIST: APPROVALS STORMWATER: OTHER: 11 --�� l» -EXtS11NG 10' UT1l.. ESM I PER SP- 1248 -00 V' 1114 1 et I N 7,733 S.F. SEE ESMT DETAIL 91.48' i• • '58'03 "W 100.00' 1RACT A \s\--' 5,536 S.F. AEA COM1AON AREA N 58'031 .22' 11 &lib) 2 6,500 S.F. 11 N89'58'03 "E 100.00' or V R Sc W�� 3 7,000 S.F. N89'58'031 n 11 11 11 II 100.00' cn 4 7,000 S.F. g N69'58'03'E Z g 10' U1IL. ESMT.---04 014 .4 tvi° 08. 1 1 7 6,763 S.F. N89'58'03'E X00.00 96.81' 7`, "EXISTING 8' BORDER ESM T. PER SP-1248-00 1 LL I ■41 se � Ei CO ! • c 1 *lane .,,s Valley Mechanical Permit Application 11707 East Sprague Avenue, Suite 106 509 - 688 -0036 - Phone Spokane Valley, WA 99206 509 - 688 -0037 - Fax For Inspections, call 509 - 688 -0054 PROJECT ADDRESS: 6 5 A-4, PERMIT USE: 4 /- yam OWNER: PHONE (Daytime Contact): MAILING ADDRESS: EQUALS AMOUNT (street) (city /state) (ZIP) = OR < 100,000 CONTRACTOR: LICENSE #: n/� $15 - MAILING ADDRESS: 1532) 0,4i,ss( 4-_ __ Nrar4oQc4 k v(-1 A —'h "el 37 PHONE # -7? , FUEL BURNING APPLIANCE 6 Li X $19 (street) (city /state) (ZIP) 3 METHOD OF PA ❑ CASH ❑ CHECK ❑ =NM ❑ DATE: BANKCARD NUMBER: EXPIRES: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK tt OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE = OR < 100,000 X $15 - i 'L 2 FUEL BURNING APPLIANCE > 100,000 X $19 = 3 UNLISTED APPLIANCE (ADDITIONAL FEE) = OR <400,000 X $50 - 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X $100 = 5 USED APPLIANCE (WSEC min. AFUE rating) = or <400,000 X $50 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X 5100 - 7 BOILER/REFRIGERATION 1 - 100M BTU X $15 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $28 - 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1001 - 1,750M BTU X $57 = 11 BOILER/REFRIGERATION +1750M BTU X 595 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE - r X $10 = 1'0 13 RANGE -- X $10 = 14 DRYER - X $10 15 FUEL BURNING WATER HEATER -- I X $10 = % C' 16 MISC. FUEL BURNING APPL. - X $10 17 GAS PIPING (ea. Outlet) - X $1 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - I X $10 =, ff.. 20 AIR HANDLER (DOES NOT include ducting) = OR < 10,000CFM X $12 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X $19 = 22 EVAPORATIVE COOLERS - X $10 23 TYPE I HOOD - X $50 = 24 TYPE II HOOD -- / X 510 25 HEAT PUMP /AIR CONDITIONER 0-3 TON 1 X $12 = (. 0 26 AIR CONDITIONER 3-15 TON X $20 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 30-50 TON X $35 = 29 AIR CONDITIONER +50 TON X $60 = 30 LPG STORAGE TANK - X $10 - 31 WOOD OR PELLET STOVE/INSERT - X $10 - 32 WOOD STOVE - FREE STANDING - X $25 = MENT I .- 1 c �� vrcor . .. SUBTOTAL: 9 C.l. +� PLUS PROCESSING FEE: ±6a OO- TOTAL PERMIT FEE DUE: ❑ CASH ❑ CHECK ❑ =NM ❑ DATE: BANKCARD NUMBER: EXPIRES: AUTHORIZED SIGNATURE: 1 !PRO.]ECI ADDRESS: OWNER: 8 S j - PERMIT USE: MAILING ADDRESS: (street) CONTRACTOR: PHONE (Daytime Contact): (city /state) (7-LP) MAILING ADDRESS: !S _32/ / /h /SS ✓ate/ e Ve - cL \u 1/.6137 (city /state) Spokane ,,,,Walley 11707 East Sprague Avenue, Suite 106 509 - 688 -0036 - Phone Spokane Valley, WA 99206 509 - 688 -0037 - Fax For Inspections, call 509 - 688 -0054 Plumbing Permit Application (street) LICENSE #: PHONE #: (ZIP) ' PLUMBING FIXTURES 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DESCRIPTION TOILETS DETAILS # OF UN URINALS TUBS WATER CLOSET, BIDETS 3 SHOWERS (PER TRAP) SINKS BATH, STALL, ON -SITE BUILT DISHWASHER LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP /CULINARY/MEAT CLOTHES WASHER GARBAGE DISPOSAL WATER SOFTENER ELECT. HOT WATER TANK FLOOR DRAINS NOTE: IF GAS, SEE MECHANICAL FOUNTAINS, DRINKING AREA, CASE, COIL, TRENCH, CONDENSATE WATER PIPING/DRAIN -IN WASTE, VENT, PLUMBING REVERSAL SEWAGE EJECTOR INSTALLATION, ALTERATION, REPAIR, REVERSALS WATER USING DEVICE CROSS CONNECTION DEVICE SPRINKLER SYSTEM GRINDER, SUMP PUMP ICE AND /OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS INTERCEPTORS MEDICAL GAS per outlet MISC. PLUMBING FIXTURE GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK NITROUS, OXYGEN METHOD OF PAYMENT MINIM ❑ CASH VISA' ❑ CHECK ❑ DATE: 3ANKCARD NUMBER: EXPIRES: 1UTHORIZED SIGNATURE: FS X COST EQUALS AMOUNT X $6 X $6 X $6 X $6 = / 7 X $6 = 1 -- X $6 X $6 X $6 (--_. X $6 - X $6 = X $6 •, X $6 - X $6 - X $6 X $6 = /, X $6 X $25 = X $6 - X $6 - X $6 = SUBTOTAL: 96 ()° PLUS PROCESSING FEE: C TOTAL PERMIT FEE DUE: City of PERMIT # PW 03- Eo SPOKANE VALLEY UTILITY RIGHT — OF — WAY APPLICATION AND PERMIT PUBLIC WORKS DEPARTMENT Date project starts Date Project ends (Please call for final inspection) APPLICATION Location of property involved (or address) 620 w Name of company j i C- Address of company /S" 3 21 M c 5 S 1 Contractors name phone Contractors address phone Contractors registration Number Expiration date Right of Way: Pavement or sidewalk intrusive. Yes Intrusive outside of pavement or sidewalks. Yes No Length of cut No ft. Depth of cut ft. Width of cut ft. Direction of cut Contact person 1 Address of contact 2 S� 14 � Phone 1, - Please explain in detail the description of the activity proposed. 4 � PP r I hereby authorize the City of Spokane Valley to charge this permit fee to my charge card. Visa mastercharge - - -- - - - _ Valid Date Print name of holder Signature PERMIT: Restoration: Permanent Type of back fill to be used: gravel Temporary Crushed CDF IS A COPY OF A BOND DEPOSITED WITH THE CITY OF SPOKANE VALLEY ? A COPY OF THE CITY / UTILITY LIABILITY INSURANCE POLICY MUST BE ON FILE AT THE CITY. PERMIT FEE $ sia- Approved INSPECTION FEE $ R -O- WAPP. V-t23 Date CALL 24 HOURS BEFORE INSPECTION NEEDED Phone 509- 688 -0036 Fax 509- 688 -0037 1 Ss ') 4 /a /7'; 4 /earl b96-Ar ,i;Pe /e)- dirt/ ,/'/) 4 a9 G5 f P F` rrl 4 .0 3 6_/e7- 0 3 C .z 7.2 S 0 7r2 ' 7 2, ) 7- 3c_v /97\-C /37y 2 3c9 q33Y57 /0 ,2 or -2 CO ,Ct L/ /C-vo A LA.- e_ 5/* 420 /2&771, / s 3 •