2005, 12-05 Permit App: 05004541 AdditionV
Spokane
valley
Community Development
Permit Center
11707 E Sprague Ave, Suite. 106,
Spokane Valley, WA 99206 n r n1
(509)688-0036 FAX: (50MR -Qp.S7� \E \\ V 1 II Il
www.s okanevalle .o tri) l
Residential Construction
Permit Application
PERMIT NUMBER:1S l
PERMIT FEE:
u ❑ New ConstrJ\ cti� 1
rc�t" d�ti t"ir►II oriel
o Other:
o Accessory Bldg
o Deck
SITE ADDRESS /'/I5' S . 816I� gel ,
ASSESSORS PARCEL NO: 45 t
Z' • Z5 7 1 LEGAL DESCRIPTION: V6R4 P7 C F 6)5'0 51 17 FT of p/zlco FT
c .7_ EKC-
Buildiig owner.-='=,;.:
Name: 6; IIV SO 4 -I -15R £'i0.t-LL
Address: J µ 1 5 5• 6/4,%z ,e .
�"
City: 5.ri/Z . Va.ile y Zip: 9/Z --/L
Phone: /y91- q0 5 Fax:
Contact`_Persou°51:
Name: 8; ()) G/tete
Phone: Re?) - 9 6a c
Describe the scope of work in detail:
:Contractor.: ,;/1 Y4 7 I i f, r'.:'
DIMENSION 0
�x
Name: En t^ i g u e_ /-1-ex- Yvl a in_Address:
TOTAL HABITABLE SPACE:
/las—
MAIN FLOOR TO SQ.
FTG: 697
G
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
City: Zip:
GARAGE SQ. FTG:--,DECK/COV.
2,01 3j D St/
PATIO SQ. FTG:
Phone: 8 79 - 7 '7 g FFqax: 0/-
U �1
3 6
{{
Lic No: MR6Li1,7(x9EXp•��Date:
SEWER"OR SEPTIC?
City Business Lic No:
Cost of Project:'-,
$ 34, 5-03.o0
**************Tbe following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSION 0
�x
# OF STORIES:
TOTAL HABITABLE SPACE:
/las—
MAIN FLOOR TO SQ.
FTG: 697
2"D FLOOR SQ. FTG:
ZO$30 -G 3e
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:--,DECK/COV.
2,01 3j D St/
PATIO SQ. FTG:
30% SLOPES ON
P ARTY:
# OF BEDROOyS:
CONSTRUCTION TYPE:
HEAT SOURCE:
SEWER"OR SEPTIC?
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
Signature
Date 72- 0 _5
Method of Payment: (Faxet permit applications will only be accepted with major bankcard)
0 Cash 0 Check 0 Mastercard 0 VISA
Bankcard #: Expires: VIN#:
❑ Other
Authorized Signature:
REVISED 8252005
S ikar► ems'`
4.0I.s Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
w ww.sookanevallev.ore.corn
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ®Residential
SITE ADDRESS: /71 5• S • 6 fc&/4
_SP lira Vale/ , tAJ& 9gz-/Z,
Building owner i i/NI/� d -L -.f SQ
C) a.1r14 - ..
# OF UNITS
Name: - «v
G: y'
Phone: l— % J- / D p 5 Fax:
=
TOTAL AMOUNT
1' -
Address: /// 5 - S . 61 tz - 1
City: ?ak. V/(. State: Clift
Zip:
99�/to
Contractor j14
f3 y,,. !d • t -'
%.:..
,
Ekt.Ir; (�4L�_
/44-t
Phone: 79 ' 791 7 Si Fax:
X
56.00
_Name:
Address: �j
City : State:
Zip:
License No:
X
City Business License No:
=
Contact' ..
SHOWERS (PER TRAP)
1
X
Name:
=
Phone:
5
SINKS
AUTHORIZED SIGNATURE:
REVISED E/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2---•
X
$6.00
=
2
URINALS
X
56.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR. FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR. PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$8.00
=
DISHWASHER
X
$6.00
=
.6
7
CLOTHES WASHER
X
$6.00
=
5
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS. SEE MECHANICAL
I
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
=
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
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER. HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
=
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
58.00
=
19
MEDICAL GAS (per outlet)
NITROUS. OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAIJSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH V. CHECK 0 VISA 0 MASTERCARD
Card# EXPIRES:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED E/26/05
Project Number: 05004541 Inv: 1
, Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 12/05/2005 Page 1 of 2
Permit Use: ADDITION TO RESIDENCE
Setbacks: Front
Left: 30 Right: 87 Rear: 135
Contact
Address
C - S - Z
Phone
Group Name
Site Information: Project Name.
Plat Key: 002753 Name: VERA
CLARK, BILLY
1415 S BLAKE RD
SPOKANE VALLEY , WA 99216
(509) 891-9085
District F
Parcel Number: 45224.2571 Block:
SiteAddress: 1415 S BLAKE RD
Location:: CSV
Zoning: UR 3.5
Water District:
Lot:
Owner: Name: CLARK, BILLY
Address: 1415 S BLAKE RD
SPOKANE VALLEY , WA 99216
Hold: ❑
Area: ;,000.00 Acres Width: 117 Depth: 300 Right Of Way (ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Released By: - - - - - - - -
Plan Review
Originally Released: 12/02/2005 By: cjjanssen
Released By:
Sewer Review
Permits: ,
Originally Released: 12/05/2005 By: TMELBOU
Released By: -- - -
Originally Released: 12/02/2005 By: cjjanssen
Operator: CJJ Printed By: CJJ
Print Date:
12/05/2005
Project Number: 05004541 Inv: 1
, Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/05/2005 Page 2 of 2
Building Permit
Contractor: MR BUILD IT Firm: MR BUILD IT
Address: 1028 E HEROY Phone: (509) 879-7978
SPOKANE, WA 99207
This Application: Total Project:
Description Gra Type Notes So Ft Valuation Sq Ft Valuation
2ND FLOOR R-3 VB 638 $47,645.84 638 $47,645.84
GARAGE U-1 VB 547 $10,393.00 547 $10,393.00
RES ADD R-3 VB 697 $52,051.96 697 $52,051.96
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Notes:
Totals: 1,882 $110,090.80 1,882 $110,090.80
Units Unit Desc
1 SELECT
I SELECT
1 SELECT
Fee Amount
$1,055.35
$4.50
$422.14
Permit Total Fees: $1,481.99
Payment Stnntnary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,481.99 $1,481.99 $0.00 $1,481.99
$1,481.99 $1,481.99
$0.00 $1,481.99
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: 12/05/2005