2006, 07-14 Permit App: 06002727 Tear Off, ReroofProject Number: 06002727 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: TEAR -OFF CEDAR SHAKE & RE -ROOF WITH Contact: WOOTEN, DAVID C & AMGELA S
COMPOSITION SHINGLES Address: 1918 S CONKLIN ST
C - S - Z: SPOKANE VALLEY, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 434-8618
Group Name:
Site Information: Project Name:
Date: 07/14/2006 Page 1 of 2
Plat Key: 002220 Name: RIDGEMONT EST NO 2 District: East
Parcel Number: 45251.0208 Block: Lot:
SiteAddress: 1918 S CONKLIN RD
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: .00 Acres Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Permits:
Contractor: OWNER
Owner: Name: WOOTEN, DAVID C & AMGELA S
Address: 1918 S CONKLIN ST
SPOKANE VALLEY, WA 99037
Hold: Li
Depth: 0 Right Of Way (ft): 0
Building Permit
Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Su Ft Valuation
1&2 FAMILY R-3 VB TEAR -OFF 0 $3,500.00 0 $3,500.00
/ RE -ROOF
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
DISH WASHERS
Totals: 0 $3,500.00 0 $3,500.00
Units Unit Desc
1 SELECT
1 SELECT
Permit Total Fees:
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Fee Amount
$97.25
$4.50
$101.75
Units Unit Desc
2 NUMBER OF
2 NUMBER OF
1 NUMBER OF
Fee Amount
$12.00
$12.00
$6.00
Permit Total Fees: $30.00
Operator: MT Printed By: MT Print Date: 07/14/2006
. Project Number: 06002727 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 07/14/2006 Page 2 of 2
Payment Summary:
Permit Type
Building Permit
Plumbing Permit
Fee Amount Invoice Amount Amount Paid Amount Owing
$101.75 $101.75 $0.00 $101.75
$30.00 $30.00 $0.00 $30.00
$131.75 $131.75 $0.00 $131.75
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: MT Printed By: MT Print Date: 07/14/2006
•
SliolianeValley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane ValleyWA 99206
(509)688'0036 FAX: (509)688-0037
Community Development ^ww.spokaomNey.orc.mm
Reroof Construction
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ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Name:
A‘,127. 4N1a4 S
Address: /9
erso
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Phone:
Describe the scope of work in detail:
7,10car off
Cost of�� project
~ ~
DISCLAIMER
The permitmeverifies, acknowledges and agrees bytheir signaturethot 1) If this permit is for constructon of or on a
dwelling, the dwelling isfwiII be served by potable water. 2) Ownership of this City of Spokane Vafley Permt inure to the
propertyowner. 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 VaIIey Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City ofSpokane VaUay
Permit isnot opermdorapproval for any vio(aUonoffederal, state orlocal |avvm.codes orordinances. G) Plans or
additional information may be required to be submitted, and subsequently approved before this application can be
processed.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Signature
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
Fl Cash FI Check
Bankcard #:
Authorized Signature:
REVISED 8/232005
[11 Mastercard
Expires:
VISA
El Other
Name:
Address:
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
7,10car off
Cost of�� project
~ ~
DISCLAIMER
The permitmeverifies, acknowledges and agrees bytheir signaturethot 1) If this permit is for constructon of or on a
dwelling, the dwelling isfwiII be served by potable water. 2) Ownership of this City of Spokane Vafley Permt inure to the
propertyowner. 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 VaIIey Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City ofSpokane VaUay
Permit isnot opermdorapproval for any vio(aUonoffederal, state orlocal |avvm.codes orordinances. G) Plans or
additional information may be required to be submitted, and subsequently approved before this application can be
processed.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Signature
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
Fl Cash FI Check
Bankcard #:
Authorized Signature:
REVISED 8/232005
[11 Mastercard
Expires:
VISA
El Other
W1s1
alley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. spokanevalle v.ore
Plumbing Permit Application fl Commercial
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
SITE ADDRESS:
Building Owner
Name:
!
/
Phone:
Fax:
Address:
#7`
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C
62,4//G1_
/A./
c7--CiTy:5'w//%NE
//4�Ci6'y
State: `�
Zip:
ODI
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
2
URINALS
X
$6.00
3
4
TUBS
X
$6.00
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
z
X
$6.00
6
DISHWASHER
X
$6.00
7
8
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
x
$6.00
10
ELECTRIC HOT WATER TANK
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 DISPOSAUSYS
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
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: