2004, 07-30 Permit App: BLD-04-07197 Additions�1"
.MiI1
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s): �t
Legal Description:
PERMIT DESCRIPTION:
Building Permit EI in Use
Relocation
LC ` ({•-</L
❑ Grading 0 Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: de 6CaLr'S
Phone: q?..� 4e96Y Fax:
dr ss:
State ip Code
Contractor:
Phone:
Address:
P/Bco C,p,s
Fax:
City
State
WA State Contractor License #:
Z
Zipcity
0 Applicant:
Phone: 946, 5/ �- F
Addre s: A //
,2 /7,4-e 0 TA. . C51') 2-
City State ip Code
0 Architect:
Phone:
P/L? crA,sF
Address:
Fax:
A4 f _ 072 4 f ontact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS: 3�
# OF STORIES: .
MAIN FLOG TO SQ. FTG:
2Nu FLOOR SQ, :
UNFIN BASEMENT SO. FTG:
FINISHED flp4§EMENT SQ. FTG:
GARAGE SQ: FTG:
. DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION T!YP '
HEAT SOUtykl
# OF BEDROOMS:
TOTAL HABITABLE S .ACE:
IMPERi OUS SURPCE AREA:
COST OFOJECT:
�
3O% SLOPE ON PROPERTY:
SEWER SITE SEPTIC
SYSTEMJ1
Sinklane
4,Valley
MECHANICAL. PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: Permit Use:
Owner:
Mailing Address:
Phone (Daytime Contact):
City
State
Contractor: License #: Phone #:
Mailing Address:
Zip Code
c
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
*OF
UNITS
X
COST
N,
TOTAL
AMOUNT
1
FUEL BURNING APPLJANCE
Equal to or less than 100,000
X
515.00
2
FUEL BURNING APPLIANCE
More than 100,000
X
519.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
4
UNLISTED APPLIANCE (Addtlional Fee)
More than 400,000
X
5100.00
-
5
USED APPLIANCE (WSEC min. AFUE
rating)
Equal to or less than 400,000
X
550.00
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
5100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515.00
8
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 BTU
X
557.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
595.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
13
RANGE
X
510.00
14
DRYER
X
510.00
15
FUEL BURNING WATER HEATER
X
510.00
16
MISC. FUEL BURNING APPLIANCE
X
510.00
17
GAS PIPING (each outlet)
X
51.00
-
18
DUCT SYSTEMS
X
510.00
=if-
-et
19
VENTILATING FANS
X
510.00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
512.00
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
519.00
22
EVAPORATIVE COOLERS
X
510.00
--,
23
TYPE! HOOD
X
550.00
=
24
TYPE II HOOD
X
510.00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
26
AIR CONDITIONER
3-15 TON
X
520.00
27
AIR CONDITIONER
15-30 TON
X
525.00
28
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
30
LPG STORAGE TANK
X
510.00
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
525.00
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD ft:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
141-0"
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EXISTING DECK
EXISTING RES.
4924 N. BOULDER
11 NEM
leo e& FT.
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OC'ife1ING
RIETAININ Gar
WALLS
EXISTING STORM
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1';X1>3TING INLET
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DR !AWAY!
ADDRESS
E
ROAD wont
FRONT
COMMENTS
REVIEWEDay
TH
BOULDER
This site plan i!s being submitted for
obtaining a building permit and is a
representation lot the proposal:" Alt
lines/dimensions, curb lines, -structure
have been identified. Also; indiCate
bodies of water, steep s
Mrlfatca •tm:��- ■ '1 ' t
" 64711(<34—
THESE PLANS MU$T '#PT.:
ON THE JOB SITE
INDEX OF DRAUJINCz
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