Loading...
2003, 04-17 Permit App: BD03-111 Finish BasementCity of SPOKANE VALLEY PERMIT # BUILDING PERMIT APPLICATION Box 1 OWNER leo b e N.6 ( r OWNER'S ADDRESS CI JOB LOCATION /1 2 30 Z 8 ridt PHONE cS9' (– -co DESCRIq.E JOB AM A r'co Q 1 �I 6.Jrec THIS PROPERTY IS OWNED BY: SINGL PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME ©L.; ✓ver PHONE CONTRACTORS ADDRESS CITY CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT PHONE ADDRESS CITY ZIP BOX 4 SEWER AVAILABILITY WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 3RD FLOOR OTHER / BASEMENT UNFINISHED / DECK CARPORT / TOTAL / 1ST FLOOR / 2ND FLOOR /©2 sPc-- BASEMENT — BASEMENT FINISHED / GARAGE / HEIGHT TO PEAK OF BUILDING FT. BOX 8 (' SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT ( ) NEW CONSTRUCTION ( —) EXISTING STRUCTURE TOTAL AREA OF PROPERTY 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) vIETHOD OF ] CASH )ATE: crrt c>r �pt�l�.ile 4 ,. Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax PROJECT ADDRESS: DESCRIPTION DETAILS PERMIT USE: X COST OWNER: l C,,,.., 6 //;H_5 l 1 PHONE (Daytime Contact): g yf_ 2.n eji MAILING ADDRESS: fl ) X 22 rc c( 161 (p=Iaiko iL((€ 451 9s Z 2 (street) U (city/state) I (ZIP) X CONTRACTOR: = LICENSE #: TUBS MAILING ADDRESS: X $6 PHONE #: 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 (street) $6 (city/state) (ZIP) 5 PLUMBING FIXTURES SANKCARD NUMBER: IUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6 = 2 URINALS X $6 = 3 TUBS X $6 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 X $6 - 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 1 X $6 = 6 DISHWASHER X $6 7 CLOTHES WASHER 1 X $6 - 8 GARBAGE DISPOSAL X $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 14 SEWAGE EJECTOR GRINDER, SUMP PUMP 1 X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, 51 EAMER, 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 VISA :_._._._:.__.. SUBTOTAL: PLUS PROCESSING FEE: $35.00 ■ ■ TOTAL PERMIT FEE DUE: 30_0c SANKCARD NUMBER: IUTHORIZED SIGNATURE: SpU'��,arle .iiMdlley Mechanical Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax PROJECT ADDRESS: DESCRIPTION OF WORK PERMIT USE: OWNER: X PHONE (Daytime Contact): MAILING ADDRESS: AMOUNT (street) (city/state) (ZIP) CONTRACTOR: LICENSE #: MAILING ADDRESS: = PHONE #: 2 (street) (city/state) (ZIP) METHOD OF PA ❑ CASH ❑ C DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE - OR < 100,000 X $15 = 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 $100 - 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 - IOOM BTU X $15 = 8 BOILER/REFRIGERATION 101- 500M BTU X $28 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 = 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 $10 - 15 FUEL BURNING WATER HEATER - X $10 16 MISC. FUEL BURNING APPL. - X $10 = 17 GAS PIPING (ea. Outlet) - X $1 - 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - X $10 = :20 f�i 20 AIR HANDLER (DOES NOT indude ducting) = OR < 10,000CFM X $12 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X $19 = 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 = 24 TYPE II HOOD -- X $10 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 $25 = 28 AIR CONDITIONER 30-50 TON X $35 29 AIR CONDITIONER +50 TON X $60 = 30 LPG STORAGE TANK - X $10 = 31 WOOD OR PELLET STOVE/INSERT - X $10 = 32 WOOD STOVE - FREE STANDING - X 525 = VI.ENT fast SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: ,206:V DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: