2010, 03-03 Permit App: 10000538 Finish BasementPermit Center
crn or 11703E o e�Suite B-3
Spokacoos�n]e ��9206
Val'(514 t'':&,0,��0tt3�� ((�,,Q..;�509)688-a 037
en G dsaner aSTeyorg
ent a ,J
onstru
Community Develop
Residential
Permit Appli
PERMIT NUMBER7/L ,c5-3%
PERMIT FEE:
New Construction C Accessory Bldg
Addition/Remodel n Deck
Other:
SITE ADDRESS: 5/19 f 1 s /3 ar
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
._... -r.
-Buildtn<. .Owner:_, ,r, .. ,_r;c{ �.-_`
tContractoi4f. :p -,.a, _.....�£ __"� :`..1.'r=`=f
Name: forName:
TOTAL HABITABLE SPACE:
Address: ye) 1 S jg cif r j
Address:
State: L-A Zip: 99x06
City: 5 0/ag-4 (J, J/r
City: State: Zip:
/
Phone: a 79 _a 3 O p Fax:
Phone: Fax:
GARAGE SQ. FTG:
Contractor Lic No: Exp Date:
cContaCtiPeiiIthi ?z� .= , �. -�',? )`.,:�c. c:'i "�� � ' >-�� �' �:� '-`
# OF BEDROOMS:"
a
City Business Lic. No:
HEAT SOURCE:
SEWER OR SEPTIC?
Name: 1o,4s-, o/ 4,01,rrf r/;rdr-4-"
Phone: 2 i 9-) 3 0 0
Describe the scope of work detail:
C, CJ,r �tir,,Nnt 9A /nt•e,_
ci
/ Cost of F
In-1)/s /SArr PPoe%/roject• $/ °°o., 7/,�",
,00t
000.0°
Proposed Use:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
2"D FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
INISHED BASEMENT
SQ. FTG: iOyreid
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:"
a
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE/
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 2/15/07
❑ Check
❑ Mastercard
Expires:
DATE: /tint/ a&'0
❑ VISA
VIN#:
Sil kannee
celc Valley.
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
penin itcenteraspokanevaflev.ore
Community Development
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial
Residential
SITEADDRESS: 40jj -f. Rale& ?-4 S?O Jtfl V&tLLAj W Yr °K2 -OL
Building Owner
Name: /t,16( nt ' JCV e(AN Fri edvtAet✓t Phone: 1.1 ci. 130D Fax:
"-/I
Address: 40 I S . got iC i Ci State: Zip
ty
12 a( SPPKa.0 *Lilt VV TI 4420 (0,,
Contractor .. .. .. > - ._ - - - - - _ _
Name. Phone: Fax:
Address City: State: Zip:
License No: City Business Lic:
Contact/Project Manager - - -, - ,.
//
Name' ,l..Air, r Tod, ,cr�IM•-+ Phone a. -7i - aj 00
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
/
URINALS
TUBS
SHOWERS (per trap)
%
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH
Card#
SIGNATURE
❑ CHECK ❑ VISA ❑ MC
EXPIRES:
VIN.
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http //www.spokanevalley org/uploads/Community_Development/Documents/Porins/Building/PlumbingPermitApplication040309 doc
Project Number: 10000538 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 3/3/2010 Page 1 of 2
Permit Use: FINISH BASEMENT - INTERIOR Contact: FRIEDMAN, JORDAN D & ANDREA L
WALLS/SHEETROCK, DOORS, TRIM- Address: 4011 S BATES RD
BATHROOM C - S - Z: SPOKANE, WA VALLEY 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 279-2300
Group Name:
Site Information: Project Name:
Plat Key: Name: WATKINS ADDITION District: Soot
Parcel Number: 45334.0626 Block:
SiteAddress: 4011 S BATES RD
Location:: CSV
Zoning: 14-4
Water District
Area: 17,305 Sq Ft
Nbr of Bldgs: 0
SF Res Urban District
Width: 0
Nbr of Dwellings: 0
Lot:
Owner: Name: FRIEDMAN, JORDAN D & ANDRE
Address: 4011 S BATES RD
SPOKANE, WA VALLEY 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information: ,
Review
Building Plan Review
Released By:
Originally Released: 3/2/2010 By: tmelbourn
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Tv a Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT F R-3 VB PLAN 1,318 $26,360.00 1,318 $26,360.00
REVIEW
FEE
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 1,318 $26,360.00 1,318 $26,360.00
Units Unit Desc
1 SELECT
1 SELECT
I SELECT
Fee Amount
$411.45
$4.50
$164.58
Permit Total Fees: $580.53
Operator: jmm Printed By: JD Print Date: 3/3/2010
Project Number: 10000538 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/3/2010 Page 2 of 2
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Fee Amount
$6.00
$6.00
$6.00
Permit Total Fees: $18.00
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $580.53 $580.53 $128.50 $452.03
Plumbing Permit $18.00 $18.00 $0.00 $18.00
$598.53 $598.53
$128.50 $470.03
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: jmm ' Printed By: JD
Print Date: 3/3/2010 '
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