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2004, 10-16 Permit App: BLD-04-07939 ResidenceSpam' ...Valley. PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: 97 /11,4- /re -B /4 /` 6 / ASSESSOR'S TAX PARCEL NUMBER(S): S / S 5/ /1/0 91 (15 LEGAL DISCRIPTION: 7I4e- SMA-TH S-13 Pt 42 T t}2 /UoRTN 570 Y. L o'P 16e Ldet r 3,4o' g, oF Titter la4,Ue,c9f 4ecord,�4 t'plo/ , ytteo•d,'m Uofcn4 °a°v)Pi4;Pei-3D, PERMIT DESCRIPTION: /7oct5e- IQaf/acevn en+ SBUII.DING PERMIT CI CHANGE IN USE CI GRADING ® MANUFACTURED HOME QRELOCATION }SIGN ®TENANT ®OFHER Liu OWNER / APPLICANT INFORMATION r o OWNER: 30.Ckt 4 jCtvle-4 14 tits,' /`v► ® APPLICANT: (2f TCI'Cv11ed / 4kt147''.'. `' "`,,(/ PHONE: 669\9c Lr49 V FAX: /� PHONE: ` ,R�(0- a/ FAX: Ad 1I'r�I`-�lAticeei ADDRESS: ).l1-! Al, 6L4 F e kit ADDRESS: aIy �, 2 L'9ka AK 07149'YYW [-Gzi7 /' CITY,STATE, ZIP CITY, STATE, ZIP G/'/ o CONTRACTOR: 6L, &/P Dyne$ LN®ARCHITECT: Cd -L �O(iL(�S /t • 9hiA" . PHONE(.D0)6 0 /-V7 11 FAX. 97-1117--- PHONE: 6023)41744/ V/ FAAXf�JO )1 S?' 9 c2_ ADDRESS: W. s%ThV yb5enr� %�.J/Y(ct/,iJ$W.S'ADDRESS: Lig551DYo51,m:sL kt-N'1ldl 10 es83S CITY, STATE, ZIP CITY, STATE, ZIP WAST -CONTRACTOR LICENSE# GL. AC j /HI 760/- 9 CONTACT: -- —1i -e- PERMIT/BUILDING INFORMATION COST OF PROJECT% j 9.3 // 30% SLOPES ON PROPERTY: /V D BUILDING HEIGHT TO PEAK: /y OCCUPANCY GROUP: 5' , /t rams/ y (i- ) i CONSTRUCTION TYPE: tiN .3 rrI/ - U NUMBER OF STORIES: / STRUCTURES ON PROPERTY: C�aJ125C-• O' -D DMQ-YM-e Dowh NUMBER of BEDROOMS: 3 CRITICAL AREAS: N ON t. FLANKING SETBACK:: /C CURRENT PROPERTY SIZE: S v�x•l9D FRONT SETBACK: 'i 5 / CURRENT PROPERTY USE: 5h* hrjlt: 'rcu+;Imo/ REAR SETBACK: 36' CURRENT SEPTIC USE: C 411 SetoevI, LEFT SETBACK: / 7 CURRENT WELL USE: 6 i4tt Wei -e rI— RIGHT SETBACK: Y. IMPERVIOUS SURFACE AREA: 44^1 BUILDING DIMENSIONS: 91 XSD MAIN FLOOR SQ FT: //IP 2N0 FLOOR SQ FT: N//'t UNFIN BASEMENT: N� FINISHED BASEMENT: /1/M GARAGE: N COVERED DECK. ialia$ NJi4 lbs -' I I DECK: I'I WA STATE NON-RESIDENTIAL ENERGY CODE 1 I BUILDING STAFF USE ONLY 1 MANUFACTURED HOME A) WIDTH: LENGTH: YEAR: PIT SET: MANUFACTURER: )Q. SIGN SQ FT OF SIGN: HEIGHT OF SIGN: # OF SIGNS: AREA OF EXIST SIGN: TYPE OF SIGN: RELOCATION 47,4 PREVIOUS ADDRESS: PROPOSED USE: FIRE SAFETY ViA4 FIRE SPRINKLER: PAINT BOOTH: FIREWORKS DISPLAY: FIRE ALARM: TENT: BLASTING: DATE/TIME: PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ...ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS O BOLTING FIRM NAME: INSPECTOR(S): °CONCRETE ® REINFORCEMENT PHONE: ® WELDING FAX: 1 1 IS PUBLIC SEWER AVAILABLE: 0 YES ® NO IS PUBLIC WATER AVAILABLE: 0 YES ® NO IF YES: ® COUNTY ®CITY IF YES, WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES ® NO 1S THE PROPERTY LOCATED WITHIN ASA: 0 YES ® NO PSSA: 0 YES 0 NO DATE: 1 METHOD OF PAYMENT: CASH STAFF: CHECK VISA BANKCARD A'• EXP/RES: VINY AUTHOR/ZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD se'!\t% .f ey . 10kcnH,.„-E(LVeG j Flowr� Project Address::`/ ). ani (�L14' I_ Owner: JAGI�. 4 TQvA� Fiev t �it✓1 Mailing Address• N 9-19 4 1.414 PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuitdingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 .- FOR INSPECTIONS, CALL (509) 688-0054 Permit Use: . Phone (Daytime Contact) 4°9) 6 g74'' s poputt vat( e y - .7%)./6 Gerlata� % } t ,i{ �j%C State"" Zip Code Contractor. GLAC- !70 5 �1_-ivC- License #: coLt4c_(4)949cNPhone#:o�-oS�Gl?i-�!'7'y/ Ma'ling�Alddrres�s`: W.0,,S�1S(�O *a PIA Ee I % Ra-f—tvitrul-r4 D &38Th' - /V'�►f7VL1 r-M'1,te 3( €c - City He i (1't24K/H i 1G City State Zip Code BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK #OF UNITS X COST - TOTAL AMOUNT 1 TOILETS WATER CLOSET BIDETS X 56.00 = 2 URINALS X 56.00 = 3 TUBS - - X $8.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6.00 = 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT X $6.00 6 DISHWASHER X 56.00 = 7 CLOTHES WASHER X 58.00 = 8 GARBAGE DISPOSAL 1 X ' $8.00 9 WATER SOFTENER ` - © $6.00 = 10 ELECTRIC HOT WATER TANK NOTE IF GAS, SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH,. CONDENSATE X 56.00 - = 12 ROOF DRAINS/OVERFLOW DRAINS X 56.00 = 13 FOUNTAINS, DRINKING X 58.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT PLUMBING. REVERSAL INSTALLATION, ALTERATION, REPAIR REVERSALS X $8.00 = 15 SEWAGE EJECTOR GRINDER SUMP PUMP X 36.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE B03, STEAMER, PROOFER CARBONATOR, SWAMP COOLER X - 56.00 - 17 CROSS CONNECTION DEVICE VACUUM BREAKER CHECK VALVE, ANDRPS.P.O. FOR: VATS TANKS, BOILERS X 56.00 18 INTERCEPTORS - - GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56.00 = 19 MEDICAL GAS (per outlet) NITROUS OXYGEN X 56.00 = 20 MISCELLANEOUS PLUMBING FORURE X $6.00 = METHOD OF PAYMENT: ❑ CASH I3 CHECK 0 VISA 0 MASTERCARD DATE EXPIRES - SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE:. BANKCARD NUMBER: AUTHORIZED SIGNATURE: 001\i, *lane 4,,Valley Project Add ess: . Owner:. Mailing Address: evtt Contractor `/ M in_g Address: 1 R. ircert 4 elec4 A 1,4re tl Ctt•'te- Ct+yl tr Vk f f vt f -{4w MECHANICAL PERMIT APPLICATION City of Spokane Valley Corr munily Development Department BuitdingOivlsion 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509)688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, . CALL (509) 688-0054 Permit Use: Phone (Daytime Contact)(1C j IA) •-I/ 1 _ -;3__Xelj-04704, City „ License #: l3i4f H t out State/�� `' Zi Code Phone IAXII J tel State Zip Code 1'14, A-- 1 1p-. 1_ ... Yf • �. J DESCRIPT10Nl OF WORK a.-. -if OF UNITS X COST - TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or fess than 100,000 J X 515.00 = , More ttn 100:1100 X Siam 2 FUEtBURNtING APPLIANCE 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 X $50.00 4 UNLISTED APPLIANCE (Additional Fee) More than 400,000 Equal to or fess than 400,000 X X 5100.00 $50.00 USED APPLIANCE (WSEC min. AFUE rating) g USED APPLIANCE (WSEC min AFUE rates) s More than 400000 1 X 5100.00 = 7 BOILER/REFRIGERATION 1 - 200M BTU - X 515.00 e BOILER/REFRIGERATION 101 - 500M BTU X 528.00 9 BOILER/REFRIGERATION 501 -1,000M BTU X 539.00 10 BOILER/REFRIGERATION 1,001 -1,750M BTI! X 557.00 = II BOILER1REFRiGERATION More than 1,750M BTU X 535.00 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $10.00 13 RANGE X $10.00 = 14 DRYER If [ X 510.00 - .. 15 FUEL BURNING WATER HEATER X 510.00 18 MISC. FUEL BURNING APPLIANCE X 510.00. _ 17 GAS PIPING (each outlet) X 51.00 = { 18 DUCT SYSTEMS X $10.00 = 19 VENTILATING FANS X 510.00 = 20 AIR HANDLER (DOES NOT Include ducting) Equal to or fess than 10,000 CFM X 51200 = 2t AIR HANDLER (DOES NOT include ducting) Greater than 10,000 CFM X 519.00 = 22 EVAPORATIVE COOtERS X 510.00 =. 23 {. I TYPE 1 HOOD X ^ $50.00 = 24 TYPE II HOOO X 510.00 = 25 HEAT PUMP/AIR CONDITIONER -3 TON X, 512.00 = 26 AIR CONOMONER 3-15 TON ! X 520.00 = 27 AIR CONDITIONER 15-30 TON • 1 X 525.00 = 28 AIR CONDETIONER 30-50 TON X 535.00 24 AIR CONDITIONER More than 50 TON X 560.00 = 30 LPG STORAGE TANK X 510.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 32 WOOD STOVE - FREE STANDING X 525.00 = METHOD OF PAYMENT: D CASH CHECK D VISA DMC CARD#: DATE: EXPIRES: SUBTOTAL PROCESSING FEE 535.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: Spolian�a eG aossUalley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: C. i THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit NEW SINGLE FAMILY RESIDENTIAL 214 N BLAKE RD SPOKANE WA 99212 NEW RESIDENCE - FORCED AIR ELECTRIC HAMLIN, JACK HAMLIN, JACK 18724 E LINCOLN RD OTIS ORCHARDS, WA 99027-8215 GLACIER HOMES INC 8580 W YOSEMITE RATHDRUM ID 83858 Lot: Application #: BLD -04-07939 Applied: Issued: Expires: BIk: Parcel No: 45154.1404 Phone: (509) 926-4724 Phone: Lic No: (208) 687-4441 GLACIHI960L4 Zoning: 10/16/2004 04/14/2005 General Information: TYPE OF RESIDENTIAL PERMIT VALUATION BUILDING HEIGHT TO PEAK DIMENSIONS # OF STORIES # OF BEDROOMS FRONT SETBACK REAR SETBACK LEFT SETBACK RIGHT SETBACK FLANKING SETBACK OCCUPANCY GROUP CONSTRUCTION TYPE STRUCTURES ON PROPERTY CURRENT PROPERTY SIZE SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS TUBS SHOWERS (PER TRAP) SINKS ' DISHWASHER CLOTHES WASHER ELECTRIC HOT WATER TANK WATER USING DEVICE DRYER DUCT SYSTEMS VENTILATING FANS AIR HANDLER <= 10,000 CFM TYPE II HOOD sfr 108752 14 28 X 50 1 3 48 86 17 5 N/A r-3 5-n 2 50 X 190.5 no no 2 2 1 3 1 1 1 2 1 1 3 1 1 Fees: PLAN CHECK FEE TYPE II HOOD BASIC PERMIT FEE WSBCC SURCHARGE TOILETS TUBS SHOWERS SINKS DISHWASHER CLOTHES WASHER ELECTRIC WATER HEATER TANK WATER USING DEVICE DRYER DUCT SYSTEM VENTILATING FANS AIR HANDLER <= 10,000 CFM 417.66 10.00 1,044.15 4.50 12.00 12.00 6.00 18.00 6.00 6.00 6.00 12.00 10.00 10.00 30.00 12.00 Total Calculated: 1,616.31 Deposits/Receipts: 0.00 Total Due: CITY OF SPOKANE VALLEY APPROVED FOR SUBMITTAL .Building ,�,f�))� '�,i�/_ Planning -n.�K-. ./�o_ .2_ PUbtic Works {%X.P.7,10/, ¶w o OK - THIS IS NOT A RECEIPT 1,616.31 �,l ' tEVIEWED FOR CODE COMPLIANCE S 2/ALLEY B ILLDDII G DIVISION/y/p / 1402-04W Q �\ c t a a1 C} a, Cj 76Q\ C\ 0 7 ? 4 Tyr 2r\ Cfr /5//oAc ieD ak