2010, 12-30 Permit App: 10004170 ResidenceCommunity Development
Residential Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
PERMIT NUMBER:
PERMIT FEE:
YiNew Construction
n Addition/Remodel
n Other:
Accessory Bldg
Deck
SITE ADDRESS:
121 !o • ? (iuor
ASSESSORS PARCEL NO: LEGAL DESCRIPTION: 20r / (L vc3 1
Building Owner: ✓e,. ;N /,tom M .. 1eki piotes. ac.
Name: L _ fi_ Zi --C.
/
Name: ye(A4 0,644,,,,,/$ cS ILC.
Address: I Z , ,A? y �n Dei 3
Z Ai.
City: Sp o l� 4 G t 4I/, State: 144
City: �M /' , nL �d, A( State: w/4 _ Zip. `04
1%%Y_,
Phone: W��'
L `ice Fax: -,1_r Q22._ 0//9+.3_
Contact Person
Name: Ke(,, „
Phone: 017— G7 <l�
Contractor:
DIMENSIONS:
5.-S( X' s�/-
/
Name: ye(A4 0,644,,,,,/$ cS ILC.
Address: (21_ au, AG 14717 „t
City: Sp o l� 4 G t 4I/, State: 144
Zi j04
Phone: ,)17-47 Gro Fax: c,
— 0/9)--
Con tr�cto��� S��
ll �4xpDate: q-/2 -//
CBusiness
City Lic. No:
DEC COV. ATI SQ. FTG:
/� o ��
Describe the scope of work in detail: Cost of Project: $ 70, cc7
fe5f-de-7-6/ /-6 t
Proposed Use:
**************The following MUST be complete: (write N/A if not annhicablel**********************
HEIGHT TO PEAK:
0 /
DIMENSIONS:
5.-S( X' s�/-
# OF STORIES:
TOTAL HABITAB SPACE:
/2-39
MAIN FLOOR TO SQ.
FTG:' D /2(3c
2"" FLOOR SQ. FTG:
P/4
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BAS M NT
SQ. FTG:/
GARAGE SQ. FTG:l0�
-' 10
DEC COV. ATI SQ. FTG:
/� o ��
30% SLOPES ON
PROPERTY: /�fl
# OF BEDROO :
CONSTRUCTION TYPE:
HEA SOU •
SEWER OR SEP -116?
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
DATE: /2,-.25b— /0
❑ Mastercard El VISA
Expires: VIN#:
Community Development
Mechanical Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-003
www.spolcanevalley.org
7
PERMIT NUMBER:
PERMIT FEE:
Commercial Residential
SITE ADDRESS:
DoJlyd
Building Owner terii/(4 .Ml, , G0e„ ies
k�'+/L L
`
Name:it) .
Phone: j7_6700Fax:
Address: /2Z. N• ec l MD Q 41 3
/�C'
City: lQO C / �`L State:
vo' `r
,
Zip:79, c
Contractor``
1
Name: I` �1• /4, a ti •
A tie. n
Phone: l 17 - 4,7 cc,
Oa
Fax:
12
_ d/
_3---
Address:Ai. 072,1d 143
y
City: k��,�`
"7
State:
n,
Zip: �9d�
,/
License No:
�V2�/"1H��f�3
City Bfi�mess Lic:
Contact
Name: //etf i' . itidaden
Phone: 217 _ 6,7 00
DESCRIPTION OF WORK
# OF UNITS
X
COST
= TOTAL AMOUNT
FUEL BURNING APPLIANCE
Equal o or less than 100,000
X
$12.00
/Z •00
2
FUEL BURNING APPLIANCE
3
UNLISTED APPLIANCE (Additional Fee)
ore than 100,000
o or less than 400
X
$15.00
Equal,000
X
$50.00
4
UNLISTED APPLIANCE (Additional Fee)
IV ore 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)
M
ore than 400,000
X
$100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
8
BOILER/REFRIGERATION
01 - 500M BTU
X
$20.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
11
BOILER/REFRIGERATION
Molle than 1,750M BTU
X
$60.00
12
13
14
15
16
GAS LOG, GAS INSERT, GAS FIREPLACE
RANGE
DRYER
FUEL BURNING WATER HEATER
MISC. FUEL BURNING APPLIANCE
J
X
X
X
X
X
$10.00
$10.00
$10.00
$10.00
$10.00
17
GAS PIPING (each outlet)
X
$1.00
2-00
18
DUCT SYSTEMS
X
$10.00
19
VENTILATING FANS
3
X
$10.00
1D,. C71D
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)
Grea
ter than 10,000 CFM
X
$15.00
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE HOOD
X
$50.00
24
TYPE II HOOD
X
$10.00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
26
AIR CONDITIONER
4-15 TON
X
$20.00
27
AIR CONDITIONER
15-30 TON
X
$25.00
28
AIR CONDITIONER
30-50 TON
X
$35.00
29
AIR CONDITIONER
ore than 50 TON
X
$60.00
30
LPG STORAGE TANK
X
$10.00
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
32
WOOD STOVE - FREE STANDING
X
$25.00
33
REPAIR & ADDITIONS
X
$15.00
34
VENTILATION SYSTEMS
X
$12.00
35
VENTILATION MECHANICAL EXHAUST
x
$12.00
36
INCINERATOR - RESIDENCE
X
$19.00
37
INCINERATOR - COMMERCIAL
X
$22.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
PIRES:
VIN:
SUBTOTAL
PROCESSING FEE
91 On
$35.00
TOTAL PERMIT FEE DUE:
tt9.b0
Sliaane
m•••011alley
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Plumbing Permit Application n Commercialrik Residential
PERMIT NUMBER:
PERMIT FEE:
SITE ADDRESS: 1 21 V
S - aoLIvy
Building Owner 1%^ f /did �m�
� O
tic
Name:
�-OT ��v- "et. LL.....
Phone:
Fax:
92,� - o/.7,s
Address: /22. /i% /) O✓d
4.3 City: ,,fo `Vm L wk-
State:
a/14.„ Zip: 147.106
/Qeti
Contractor
Name:
zicPhone: jr_CFax:
Address: ,,00_�
Z2, /�/ 1�L lhv� �
3
Ci eei
���
State:
Zip:
�� - ��aL
License No:
/< (er,N/-t,P•y 3
City' iness�^G
Contact
Name: I/ ` l
Phone: .1/7 „ L7 coo
DESCRIPTION
OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
Z.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
Z, 17D
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
a4. va
6
DISHWASHER
X
$6.00
G. oci
7
CLOTHES WASHER
X
$6.00
. ex,
8
GARBAGE DISPOSAL
1
X
$6.00
G. or,
9
WATER SOFTENER
X
$6.00
10
ELECTRIC WATER HEATER
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 ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
bG. CO'
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Approach Permit Application
PERMIT NUMBER:
PERMIT FEE:
PROJECT ADDRESS /2,1 S • ( Ala i"
START DATE
ANTICIPATED COMPLETION DA1h
Building Owner: 1 A / Aden gary, LLC,
Name: Lb r5 i./ - LA/VA Lem
443
Address: ?Z,
City:
Phone: /'7 — `%icx)
Contact Person
Contractor:
State: , Zip: x
Fax: 922.-019,5—
Name:
Phone:
tell- G7bD
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions
Name: eoyek
Address: f ZZ
•e., 42/)7_3 //i:
d3
City: r^2'^L 1/16I'i'y
Phone:.�
State: 404 Zipef
Fax: 922 b/9
Contracto c No: zzikaExp Date: 47►/ 2 /r
City Business c.No:
rcial/I
al Road Se
(\\
eway
Construction
Bond/Insurance certification must be on file ith the city.
DISCLAIMER
The permittee verifies, acknowledges and agrees by their signatures 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 ofPayment:•
❑ Cash ❑ Check
Bankcard #:
Authorized Signature:
REVISED 3/9/06
Date a Q - /c,
❑ Mastercard ❑ VISA
Expires: VIN#:
Project Number: 10004170 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/30/2010 Page 1 of 3
Project Information:
Permit Use: SFR W/ATT GAR
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
Contact: KEVIN MADDEN HOMES, LLC
Address: 122 N RAYMOND #3
C - S - Z: SPOKANE VALLEY, WA 99206
Phone: (509) 217-6700
Group Name:
Project Name:
District: East
Parcel Number: 45233.4501 Block:
SiteAddress: 1216 S BOLIVAR LN
Location:: CSV
Zoning: R-3 SF Res District
Water District: 010 VERA
Lot:
Owner: Name: LOTS N LAND LLC
Address: 122 N RAYMOND RD
SPOKANE VALLEY, WA 99206
Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review
Released By:
Originally Released: 12/30/2010 By: tmelbourn
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released: 12/29/2010 By: cjjanssen
Released By:
Originally Released: 12/29/2010 By: jdavis
Operator: JD Printed By: jmm Print Date: 12/30/2010
Project Number: 10004170 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/30/2010 Page 2 of 3
Contractor: KEVIN MADDEN HOMES LLC
Address: E. 10601 NIXON LN
SPOKANE, WA 99206
Item Description
APPROACH -CONST IN ROW
Approach
Firm: KEVIN MADDEN HOMES LLC
Phone: (509) 924-6497
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Building Permit
Contractor: KEVIN MADDEN HOMES LLC
Address: E. 10601 NIXON LN
SPOKANE, WA 99206
Description Grp Type
1&2 FAMILY R-3 VB
DECK OPEN R-3 VB
GAR WOOD U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Notes
Contractor:
Address:
Fee Amount
$52.00
$52.00
Firm: KEVIN MADDEN HOMES LLC
Phone: (509) 924-6497
This Application: Total Project:
Sq Ft Valuation Su Ft Valuation
1,239 $122,599.05 1,239 $122,599.05
100 $1,500.00 100 $1,500.00
666 $12,654.00 666 $12,654.00
Totals: 2,005 $136,753.05 2,005 $136,753.05
Units
1
1
1
KEVIN MADDEN HOMES LLC
E. 10601 NIXON LN
SPOKANE, WA 99206
Item Description
DUCT WORK SYSTEM
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS 1 DUCT
Unit Desc
SELECT
SELECT
SELECT
Permit Total Fees:
Mechanical Permit
Units
1
1
1
2
3
Fee Amount
$1,200.95
$4.50
$480.38
$1,685.83
Firm: KEVIN MADDEN HOMES LLC
Phone: (509) 924-6497
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
# OF UNITS
NUMBER OF
Permit Total Fees:
Fee Amount
$11.00
$11.00
$13.00
$2.00
$33.00
$70.00
Operator: JD Printed By: jmm Print Date: 12/30/2010
Projecf Number: 10004170
Inv: I Application Date: 12/30/2010 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: KEVIN MADDEN HOMES LLC
Address: E. 10601 NIXON LN
SPOKANE, WA 99206
Item Description
TOILETSBIDETS
SINKS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
Notes:
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firm: KEVIN MADDEN HOMES LLC
Phone: (509) 924-6497
Units Unit Desc
2 NUMBER OF
4 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$24.00
$12.00
$6.00
$6.00
$6.00
Fee Amount Invoice Amount Amount Paid
$52.00 $52.00
$1,685.83 $1,685.83
$70.00 $70.00
$66.00 $66.00
$0.00
$480.38
$0.00
$0.00
$66.00
Amount Owing
$52.00
$1,205.45
$70.00
$66.00
$1,873.83 $1,873.83 $480.38
$1,393.45
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: JD Printed By: jmm
Print Date: 12/30/2010
4.4
ex.1)/5t- a21•1
LoT1 ....Toa 10.
IZIt, s, BoLzu4
LOT 1 ' /L,o 9?
PLANNING DEPT. APS OVt:D
B�
DATE: ID