2005, 03-29 Permit App: 05001008 DuplexProject Number: 05001008 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 03/29/2005 Page 1 of 3
Project Information:
Permit Use: NEW DUPLEX W/CARPORTS - ELECTRIC Contact: COURCHAINE, SAMUEL LEE
Address: 4029 S BOWDISH RD
C - S - Z: SPOKANE VALLEY, WA 99206
Setbacks: Front 49 Left: 58 Right: 40 Rear: 25 Phone: (509) 928-2807
Group Name:
Site Information: Project Name:
Plat Key: Name: SHP-24-03
District: Sout
Parcel Number: 45334.9095
Block: Lot:
SiteAddress: 4029 S BOWDISH RD
Location:: CSV
Zoning: UR -3.5
Water District:
Urban Residential 3.5
Owner: Name: COURCHAINE, SAMUEL LEE
Address: 4029 S BOWDISH RD
SPOKANE VALLEY, WA 99206
Hold: ❑
Area: 23,525 Sq Ft Width: 140 Depth: 168 Right Of Way (ft): 60
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Released By:
te4c.i c)
Approach / Drainage
Sewer Review
Permits:
Released By:
6SD o 9l 1 Oa) fm Pc.v.)
Ia/9
or
Operator: K_C Printed By: K_C
Print Date: 03/29/2005
Project Number: 05001008 Inv: 1
Application
THIS' IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 03/29/2005 Page 2 of 3
Contractor: OWNER
Group: R-3 Type: VB
Total Area 2904
Building Height 14
Stories 1
Dwelling Units 2
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Description Grp Type Notes
CARPORT U-1 VB
RESIDENCE R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Item Description
DUCT SYSTEMS
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
HOOD -TYPE II
This Application: Total Project:
Sq Fl Valuation Se Ft Valuation
452 $6,780.00 452 $6,780.00
2,904 $216,870.72 2,904 $216,870.72
Totals: 3,356 $223,650.72 3,356 $223,650.72
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Firm: OWNER
Units
1
2
8
2
2
Operator: K_C Printed By: K_C
Phone
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$1,688.15
$4.50
$675.26
$2,367.91
(000) 000-0000
Fee Amount
$10.00
$24.00
$80.00
$20.00
$20.00
$154.00
Print Date: 03/29/2005
Project Number: 05001008 Inv: 1
Application
Date: 03/29/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Contractor: OWNER
Item Description
TOILETSBIDETS
SINKS
TUBS
DISH WASHERS
CLOTHES WASHER
ELECTRIC HOT WATER TANK
WATER USING DEVICES
Units Unit Desc
4 NUMBER OF
6 NUMBER OF
4 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
4 NUMBER OF
Fee Amount
$24.00
$36.00
$24.00
$12.00
$12.00
$12.00
$24.00
Permit Total Fees: $144.00
Notes: ,
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$2,367.91
$154.00
$144.00
Invoice Amount
$2,367.91
$154.00
$144.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$2,367.91
$154.00
$144.00
$2,665.91 $2,665.91
$0.00 $2,665.91
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 law's or ordinances.
Signature:
Operator: K_C Printed By: K_C
Print Date: 03/29/2005
Spokane
jUalley
BU
IEC BV
MAR 2 1 2005
MOL OON
LDING PERMIT APPLICATION WORKSHEET
Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
one: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: got? 1/45-,18,d,,3454 ,6 - 3c'Lthic iL ; t» 4- tzcr&
Assessor's Tax Parcel Number(s):
L\ -53311:c 395
Legal Description: 33 DS -h 5H Y F 3 01 AVNtt 'a 3.10S -J6 2,11. i 5 PU3 3 c 34t4 gtd„3 of
PERMIT DESCRIPTION: wp}Q�
Building Permit
[1 Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
0
o^
^U
WA State Contractor License #: Contact:
Owner:_SAbvt( cJrcltrz)1t2
Phone`, 7r-Zyo Fax: _
Address:/'yd (,,,,,-
Tkilw.a ¢-14 GJ69 x%9206,
City State Zip Code
Contractor:
Phone:
Address:
Fax:
City
State Zip Code
7
Applicant: 5e, ia.,9_.
Phone:
Address:
Fax:
City
State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
State Zip Code
P
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: Ili 4 .
DIMENSIONS:
t �X / /
(D
# OF STORIES: 1
MAIN FLOOR TO SQ. FTG: z
• 2goV
2NO FLOOR SQ. FTG:
0
UNFIN BASEMENT SQ. FTG:
0
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTZ ��Z
S
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE: D// / /•
PXQ-Evl.- G ('a
# OF BEDROOMS: X . /
(O
TOTAL HABITABLE SPACCE: //z
YY
IMPERVIOUS SURFACE AR
COST OF PROJECT:
30% SLOPES ON PI4OPERTY:
0-0
SEWER OR ON-SITE SEPTIC
SYSTEM? ,S'P.we t/
J%
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
Valuation:
# of Heads: Fire Alarm: /eD Paint Booth:
Fireworks Display: Blasting: Date/Time:
Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
❑ BOLTING
Firm Name:
❑ CONCRETE ❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ WELDING
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.
Ownership of resulting development rights granted by any issued permit inure to t e pr perty owner.
Sr
Print Name r, CotArc1Q\nt- Signature ^ YUXUL
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #:
Authorized Signature:
Expires:
VIN#:
Aral
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Cal, (509) 688-0054
Project Address: yC s tAlS�-.
Owner: Sto..„ Cov.e\na1 nt.
Mail ng Address: CIO 'Z S w � S
Con rector: S0Fr4'n-
Mailing Address:
License #:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use: Si e �(
C Phone (Daytime Contact x807
cap.tat: UPI12J
City / • State ZIp Code
Phone #:
Y Stet
Zro Code
DESCRIPTION OF WORK
0 OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
512.00
_
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400.000
X
550.00
=
4
UNLISTED APPLANCE (Additional Fee)
More than 400900
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
$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
X
525.00
10
BOILER/REFRIGERATION
., 1901 - 1,750M BTU
X
535.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
=
13
RANGE
W
X
510.00
=
,;>3.0'
14
DRYER
7
X
510.00
=
('�
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
17
GAS PIPING (each outlet)
X
51.00
=
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
p
E
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
515.00
=.
22
EVAPORATIVE COOLERS
-'
X
510.00
=
23
TYPE I HOOD
X
550.00
21
TYPE 11 HOOD
' X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
DLt • °°-
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
=
33
REPAIR & ADDITIONS
X
515.00 '
=
34
VENTILATION SYSTEMS
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE *'
X
519.00
=
37
INCINERATOR - COMMERCIAL`
-
X
522.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA .❑ MC
CARD #:
DATE:
SUBTOTAL
(+j4 ',
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: •
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Project Address: L`QQg 5 600 c.1 st.
Owner Scar Cny.cc o;1nL
Mailing Address:
�loa °1 s Row S1 c1/2.
fir
Contractor: O v> (
Maiing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use: Las (�I�trincT o n
Phone Daytime Contact): (5.3C0 nla8 -2830?
Spo►U0 Oa1Ity wl ggDOL
Cit State Zip Code
Y
License #:
Phone #:
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST •
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET. BIDETS'
y
X
56.00
=
VLt . e a
2
URINALSX
56.00
3
TUBS
[['�
7
X
56.00
=
.QLl ' c--)
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56.00
=
5
SINKS
LAVS/BASINS. BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR. PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
56.00
=
SL• `O
6
DISHWASHER
ryy10
aX
56.00
=
. 1Z.a0
7
CLOTHES WASHER
a
X
56.00
=
la O°
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
- NOTE: IF GAS, SEE MECHANICAL
)
X
$6.00
=
.t", . OC1
11
FLOOR DRAINS
AREA, CASE. COIL, TRENCH, CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
-
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
. REVERSALS
X
56.00
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
LI
X
56.00
=
. X21 c70
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
I'
I Y L) . O�
PROCESSING FEE
. 535.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
• ;:1-r,-17:4-.--i;,T • -
tn
•.1( 1 .1 • •
•
cP••,,-„—•••40•44 ' • "
•
•
• .
• .
b. et •-t•P
\ L
•
itk-S
--- "n
4? ---4
C1C Vi
.Aric•ivi•
•
This site Plan is being submitted tor the purpose 0
obtaining a building patina and is a ttue and correct •,.
reptelintatIon ot the proposal: An %math Property
linesIdimensions, curt lines, structuies and easements
' have been Identified. Also Indicated are wetlands,
bodies of ter, steep st s at other critical areas.
NUL .
Datir i ,
Signed: "A—
t ..
f
r---