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2007, 12-04 Permit App: 07004711 AdditionSpokane .FValley Community Development Residential Construction Permit Application Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)658-0037• www.spokanevalley.org PERMIT NUMBER: 17. --Ln PERMIT FEE: New Construction 4ddition/Remodel Other: Accessory Bldg Deck SITE ADDRESS: : D) • /�«✓��-- LEGAL DESCRIPTION: yet -2n PT 66 0,1a1-1 SIobfi- o(j ASSESSORS PARCEL NO: 15t-j.ILtOq yooe- o W2//D E --(C Building'Owner:- . -'; '- -_ :Conti -actor: ` Fr' Name: 1 .r1 (-C ill- �U1vt�1 ('- �'1 C(h' hL'Y)I'l.(�4 l -C_ Name: , � 1 �t�.M.i,/, L1 railT Address: Address: j 10 /1 , t!1/=(-� City: 'D Lithe State: Lai. Zip: 9?za, City: State: Zip: Phone: '1 5. - i-/L/v S Fax: Phone: 50 t.7 & - ZIt! 7i- Fax: i GARAGE SQ. FTG: , ContractorJLic No: Exp Date: Contict Person 1. , ; i_ w'': # OF BEDROOMS: City Business Lic. No: HEAT SOURCE: (la 5 SEWER OR SEPTIC? cam' Name: Phone: Describe the scope of work in detail: Cost of Project: $ / cop n cir1.r .t'lc riu i }�'r t -1 k -&h , d Proposed Use: -Ar" �y pt rv: (.t PrP -Pan, 1 **************The following MUST be complete: (write N/A if not applicable)********************** HEIGHT TO PEAK:I `ria NS1.Q& r "NY 39 # OF STORIES: 1 TOTAL HABITABLE SPACE: MAIN FLOOR TO SQ. FTG: el3(o SF RD n- 2" FLOOR SQ. FTG: e.3 UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE AREA: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: 30% SLOPES ON PROPERTY: # OF BEDROOMS: oto' JPROc-,TION`i`YPE: I\XXY" HEAT SOURCE: (la 5 SEWER OR SEPTIC? cam' 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. NATURE: , (CLINwCN�\-Q-A- Method of Payment: ❑ Cash Bankcard #: Authorized Signature: REVISED 2115/07 ❑ Check a4M 1\-amt-oR— ❑ Mastercard Expires: ❑ VISA VIN#: Sj okan Valley - Community Development Mechanical Permit Application Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokancvallcv my. PERMIT NUMBER: PERMIT FEE: n Commercial VpResidential SITE ADDRESS: c9 av fY 6_0 ate_ S f22, Kam' iJei I le y . Ltig'-!- get Z/ &o Building Owner"Name: C4, -llt} V Fax: porn. rY0 hoi 6TY-rtyct Let Phone: C�-bq' (i2s._2144 Address: 22c City: �nl-3Kcl.,VV%vQl+".State: N - ehCQ w%t Zip IC1z1 Contractor - - + - % _ . . _ - Name TPaPrrtt� Phone - Fax: (�rct Phone-7;011_sips, „1�10'� Address: City: State Zip License No: City Business Lic: Contact Name Phone: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $12 00 2 FUEL BURNING APPLIANCE More than 100.000 X $15 00 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 X $50 00 4 UNLISTED APPLIANCE (Additional Fee) More than 400,000 X $100 00 5 USED APPLIANCE (WSEC min. AFUE rating) Equal to or less than 400.000 X $50.00 6 USED APPLIANCE (WSEC min. AFUE rating) More than 400,000 x $100.00 7 BOILER/REFRIGERATION 1 - 100M BTU X 512 00 8 BOILER/REFRIGERATION 101 - 500M BTU X 520.00 9 BOILER/REFRIGERATION 501 - 1,000M BTU 10 BOILER/REFRIGERATION 1.001 - 1.750M BTU X X $25 00 535 00 11 12 ' BOILER/REFRIGERATION GAS LOG, GAS INSERT, GAS FIREPLACE More than 1,750M BTU • 410 13 RANGE 1 X x X 56000 • 510 00 $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 $1.00 18 DUCT SYSTEMS X $10 00 19 VENTILATING FANS X 510 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 $15 00 22 EVAPORATIVE COOLERS X $10 00 23 TYPE I HOOD X 550.00 24 TYPE II HOOD X $10 00 25 HEAT PUMP/AIR CONDITIONER 0-3 TON 26 AIR CONDITIONER 4-15 TON mar X $12 00 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 510.00 31 WOOD OR PELLET STOVE/INSERT X $10.00 32 WOOD STOVE - FREE STANDING X 525 00 33 REPAIR & ADDITIONS X 515.00 34 VENTILATION SYSTEMS x $12.00 35 VENTILATION MECHANICAL EXHAUST x 512.00 36 INCINERATOR — RESIDENCE X $19.00 37 INCINERATOR — COMMERCIAL x $22.00 METHOD OF PAYMENT: UCASH CARD # AUTHORIZED SIGNATURE: REVISED 8/26/05 El CHECK U VISA ❑ MC EXPIRES. VIN' SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: _ Permit Center Spokane 11707 E Sprague Ave, Suite 106 Ualley Spokane Valley, WA 99206 (509)688-0036 FAX. (509)688-0037 Community Development wwwspokanevallev ore Plumbing Permit Application n Commercial PERMIT NUMBER: PERMIT FEE: Residential SITE ADDRESS: 22o Iv . 3A B kk 1 SQa kav Q Va 11.2-q r uft1 1 92-t le Building Owner -. .:. _ _ ,- -. , -•..- .. - - �� Name: St() 'r1 `f' ///�� - i t o c' Cll.�iit�rt Phone �i �riZ�• 2.1 ti- �- Fax: Address. 220 (V;. r,fr& E, cC kCG'li City spotane State.von_ Zip: 11Gi 2 c fr Contractor.: (,3 p'. 1 1 , - Name `3-exerYu' ()roil/al PhoneFax: 'l�tvS Address: City: State: Zip: License No: City Business Lie. .Contact` _ - .. _- ., ; 4 c r, �_=:-- Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 00 2 URINALS X $6 00 3 TUBS X $6 00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 00 5 SINKS LAVSIBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 2- X $6 00 6 DISHWASHER X $6.00 7 CLOTHES WASHER X $6 00 8 GARBAGE DISPOSAL 1 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 NSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 00 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $6.00 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P B.P.D FOR VATS, TANKS, BOILERS X $6.00 18 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 21 PRIVATE SEWAGE DISPOSAL/SYS X $20 00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: ❑CASH C CHECK C VISA CMC Card# AUTHORIZED SIGNATURE: REVISED 8/26/05 EXPIRES: VIN SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: C; Project Number: 07004711 Inv: 1 . Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Date: 12/4/2007 Page 1 of 3 Permit Use: 24 X 39 RES ADDITION -ADDITIONAL Contact: GRAY HOMES, LLC BEDROOM & BATH, KITCHEN Address: 120 N LOCUST RD C - S - Z: SPOKANE VALLEY WA 99206 Setbacks: Front Left: Right: Rear: Phone: (509) 868-4905 Group Name: Site Information: Project Name: Plat Key: Name: Range District: Nort Parcel Number: 45154.1409 Block: SiteAddress: 220 N BLAKE RD Location:: CSV Zoning: R-3 SF Res District Water District: 010 VERA Area: 19,050 Sq Ft Width: 0 • Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs:' 0 Nbr of Dwellings: 0 - Lot: Owner: Name: CHARBONEAU, SCOTT R & AMY Address: 13310 E MISSION AVE # 1 SPOKANE VALLEY, WA 99216 Hold: ❑ Review Information: Review Building Plan Review Released By: Originally Released: 11/29/2007 By: tmelbourn Landuse/Zoning/HE Conditions Released By: - - - Originally Released: 12/3/2007 By: mpalaniuk Permits: Operator: jmm Printed By: JD Print Date: 12/4/2007 Project Number: 07004711 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 12/4/2007 Page 2 of 3 Building Permit Contractor: GRAY HOMES LLC Firm: GRAY HOMES LLC Address: 18621 E 4TH Phone: (000) 000-0000 SPOKANE VALLEY, WA 99016 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation RES ADD R-3 VB 936 $85,512.96 936 $85,512.96 Item Description RESIDENTIAL PERMIT FEE WSBC SURCHARGE SF PLNS RVW < 7999 SQ FT Totals: 936 $85,512.96 936 $85,512.96 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Permit Total Fees: Mechanical Permit Fee Amount $895.75 $4.50 $358.30 $1,258.55 Contractor: GRAY HOMES LLC Firm: GRAY HOMES LLC' Address: 18621 E 4T11 Phone: (000) 000-0000 SPOKANE VALLEY, WA 99016 Item Description RANGE . Units Unit Desc 1 NUMBER OF' Permit Total Fees: Plumbing Permit Fee Amount $10.00 $10.00 Contractor: GRAY HOMES LLC Firm: GRAY HOMES LLC Address: 18621 E 4TH Phone: (000) 000-0000 SPOKANE VALLEY, WA 99016 Item Description Units Unit Desc Fee Amount TOILETS/BIDETS 1 NUMBER OF $6.00 SINKS 2 NUMBER OF $12.00 SHOWERS 1 NUMBER OF $6.00 TUBS 1 NUMBER OF $6.00 DISH WASHERS 1 NUMBER OF $6.00 GARBAGE DISPOSAL 1 NUMBER OF $6.00 CLOTHES WASHER 1 NUMBER OF $6.00 Operator: jmm Printed By: JD Permit Total Fees: $48.00 Print Date: 12/4/2007 Project Number: 07004711 Inv: 1 , Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 12/4/2007 Page 3 of 3 Notes • Payment Summary. Permit Type Building Permit Mechanical Permit Plumbing Permit Fee Amount Invoice Amount $1,258.55 $10.00 $48.00 $1,258.55 $10.00 $48.00 $1,316.55 Amount Paid $0.00 $0.00 $0.00 Amount Owing $1,258.55 $10.00 $48.00 $1,316.55 $0.00 $1,316.55 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: 12/4/2007 aoo'� 1,9 PLANNING:DEPT,. A APP �PROVED EP mel DATE: P-703/07 24 Existing 9' x8'"-6'� Shed 5' Existing exf 4' Shed 16' Se r Lin 5\ Existing 39' x 28' Home 21' N 4 ' 0 13LAKE ROAD J N c a) IL