2003, 06-20 Permit App: BD-03-660 AdditionCity of
SPOKANE VALLEY
F/4x
PERMIT # 80 -12Y -
BUILDING
V 12BUILDING PERMIT APPLICATION
68g-oo3 b
bnr- 60 -V
Box 1 OWNER C A/6- S R�Tfi JOB LOCATION /V %oc..t., tv. 4 Al
OWNER'S ADDRESS y/s ,,ilfRAwo CITY Sr PHONE al3-
�o A
DESCRIBE JOB Rom 1- I m J Xaa w/
THIS PROPERTY IS OWNED B
PARTNERSHIP CO
ARRIED
BOX 2 CONTRACTOR'S NAME
c..6 AJE R
PHONE
CONTRACTORS ADDRESS CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT A/6- SGeE77/ PHONE a 93 - Co/g
ADDRESS 1%/S & E fie -k-94,0 ) • CITY ,..5p6,4- rife_ 1 w% ZIP OCe
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ o?O IC EXISTING BLDG. VALUATION $ A/A -5-`343
BOX 6 PROPERTY TAX ACCOUNT NUMBER 3--e-, 1 1/ . /6 9
LEGAL DESCRIPTION
ORcI4ARt Avg 4op /V//7 IR /ori
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR "/Zg/ Agg 2ND FLOOR /
3RD FLOOR o / 1�
OTHER G / v BASEMENT FINISHED 4040
BASEMENT UNFINISHED 0110 l 772 DECK '
/ GARAGE 5-74' l -5 24
CARPORT O / 0 TOTAL /.30`c) / C `tsv HEIGHT TO PEAK OF BUILDING
FT.
BOX 8 ()C) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
(X) NEW CONSTRUCTION
(X) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY / ?, 3/c$ SQ. FT.
IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins)
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size (if known) Also see BOX 4
BOX 11 Septic Tank — Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT DATE (OVER)
IETHOD OF
] CASH
ATE:
SC7'!Y OEkane
��
.0•Walley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Va11,y, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT p
ADDRESS: 3 O: i. l/ /� V J ow ii -A 4 it,'
PERMIT
USE: POO, D
(O .4OD-
A �/ 000eG
OWNER: 0 Q n / 6- SLEET -eel
/
, PHONE (Daytime Contact): -,
g / J
-
/ �+
MAILING ADDRESS:
. //s` S0 , /9 6/04-D i A . SPo/G4 •u t , t .
19
eP
(street) (city/state) (ZIP)
X
$6
CONTRACTOR: A\ AAeR
LICENSE it:
2
URINALS
MAILING ADDRESS:
PHONE #:
$6
-
3
TUBS
(street) (city/state) (ZIP)
'
-
PLUMBING FIXTURES
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
Q
0
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOLIIVT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
4
2
URINALS
X
$6
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
$6
-
6
7
CLOTHES WASHER
X
$6
-
c..
8
GARBAGE DISPOSAL
X
$6
-
6
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
6
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
❑ CHECK
MOM
VISA' •
_
'147.51. „
_ ._`.
SUBTOTAL:
0 Q
PLUS PROCESSING FEE:
$35.00
❑ iniffina ■
TOTAL PERMIT FEE DUE:
70_,.tm
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
Q
0
**am
oka e
_1. Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 • 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT ,� / (�
ADDRESS: 3 / v . / ! C) Lk.) M4
Il]
PERMIT n i0
USE: A GC).JLC. 4 0
/�
Q !k c,- o Z
OWNER c:. /� r 6- S 1--e-7-iii
COST
PHONE (Daytime Contact): 8 ?,S-- _,, a (D / ,R
MAILING ADDRESS:
/S --Co , /f
(44 A '
.
SPo<r4,0 . L4)0. . /c9r o
(street)
X
(city/state)
=
(ZIP)
2
CONTRACTOR: 6, ` �eR
W
> 100,000
X
LICENSE #:
=
MAILING ADDRESS:
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
PHONE #:
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
(street)
(city/state)
9100
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER:-- .,
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
=
/6-
2
FUEL BURNING APPLIANCE
> 100,000
X
$19
=
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
9100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
- or <400,000
X
$50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
815
-
8
BOILER/REFRIGERATION
101- 500M BTU
X
928
-
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
939
-
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
$57
-
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
-
13
RANGE
-
X
$10
-
14
DRYER
-
X
910
-
/04.
15
FUEL BURNING WATER HEATER
-
X
$10
-
16
MISC FUEL BURNING APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
-
X
91
-
18
DUCT SYSTEMS
-
X
910
-
O
19
VENTILATING FANS
-
X
810
-
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
X
812
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
919
=
22
EVAPORATIVE COOLERS
-
X
$10
-
23
TYPE I HOOD
-
X
850
-
24
TYPE II HOOD
-
X
910
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
-
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15.30 TON
X
925
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
$60
-
30
LPG STORAGE TANK
-
X
910
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
-
32
WOOD STOVE - FREE STANDING
-
X
925
-
HENT
- —
VISA r
SUBTOTAL:
3S
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: %L. t
DATE: EXPIRES:
BANKCARD NUMBER:-- .,
AUTHORIZED SIGNATURE: