2003, 05-13 Permit App: BD03-409 RemodelSPOKANE COURTY _
PROJECT APPLICATION WORK SHEET
SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT
1026 WEST BROADWAY AVENUE
SPOKANE, WA 99260
509-477-3675
6.P crs'. Ho,
SPECIFIC S111 INFORMATION
Street Address: zzz.,1 S. aoivisevil
Assessor's Tax Parcel Number(s):
Vf)4,41.W4-g-- J4- 57
Legal Description:
Project Description:
Ifs( frj.dtp-t isks,-facsrr PcrALOEL
prifQ3uilding Permit
0 Relocation
O Change in Use
O Grading
O Manufactured Home Permit
O Sign
O Tenant (New/Change)
O Other
- . •
OWNER/APPLICANT INFORMATION
d be contacted rellardin2 this project
KOwner i5iTai,6 dr %AAA
• Phone: 9t.7.* ser;30S—
141 Aaei. Fax
. .
plicant:
/4400%
Phone:
'------' Fax:
Mailing Address.
ZZZ% S . itiltt.)
Mailing Address:
Dimensions
Ciry, Sive, Zip
YEAANP164-- i -A4 '2%17
Ciry, State, Zip
sq. ft.
basementkssq.
Cop,LQctor Phone CFI, .. 900%
eivzo. atrt.,-: Fax
0 ArchitecilEngineer
Phone
Fax
Mailing address
770S 6--
Mailing address
Ciry, State '
/ i•I•ifiA' 9fvre___
City, State Zip
WA SSt 21C tractor license , A% IL
Vek Z 0 G I 0 GEPOL,
Contact name:
FORMATION
,...,.,
ii.". -a ;4401.
': - ''' ' ' ' '' .. • ' ' ; E''''',:" -, '"Pri-.4.,.-:•-:,,,?.>,...? -ty:;,,;
,i L" ' .„. 4.4;;;;14443.? . "P:4,tk...,','',,,
liel.,.%:`, *VI- 94- ''''''-''' . .
, .. .
Building height TO peak
# of stories
,
Main floor sq. n.
Unfinished basement sq. ft.
Dimensions
Total habitable space
2' floor sq. ft.
sq. ft.
basementkssq.
Occupancy group
Construction type
Garage sq. ft.
DFiencihed
ft.
Cosi of project
/ , (Y)1.)
Heat source (electric, gas, etc.)
SiTiokane
Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS: -0e Z ...S 5.
frygyisi,
PERMIT
USE:
# OF UNITS
X
OWNER: iVAA16)4
EQUALS
PHONE (Daytime Contact): -44 le
?e
9coll
MAILING ADDRESS:
X
515
(street)
(city/state) (ZIP)
2
FUEL BURNING APPLIANCE
CONTRACTOR: C43,4‘04.3 S
400227 .
LICENSE It: Alhawings„..
519
..
MAILING ADDRESS:
3
PHONE t:
- OR < 400,000
X
550
=
(street)
(city/state) (ZIP)
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
METHOD OF PA
CASH Dc
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR <100,000
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
..
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
550
=
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
>400,000
X
5100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
- or <400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE radng)
>400,000
X
5100
"
7
BOILER/REFRIGERATION
1 1 - 100M BTU
X
515
.,
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528
-,
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539
.,
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X .
557
.
11
BOILER/REFRIGERATION
+1750M BTU
X
595
..
12
CAS LOG, GAS INSERT, GAS FIREPLACE
X
510
-
13
RANGE
X
510
.
14
DRYER
X
510
.
15
FUEL BURNING WATER HEATER
X
510
.
16
MISC. FUEL BURNING APPL.
X
510
-
17
GAS PIPING (ea. Oudet)
X
51
.
.
18
DUCT SYSTEMS
X
19
VENTILATING FANS
Z.
X
510
.
ae,
20
AIR HANDLER (DOES NOT indude ducting)
. OR < 10,000CFM
X
512
,.
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CPM
X
819
22
EVAPORATIVE COOLERS
X
510
.
23
TYPE I HOOD
X
550
.
24
TYPE II HOOD
X
510
.
25
HEAT PUMP/AIR CONDMONER
0-3 TON
X
512
=
26
AIR CONDITIONER
3-15 TON
X
520
..
27
AIRCONDITIONER
15-30 TON
X
525
=
28
AIR CONDITIONER
30-50 TON
X
835
-
29
AIR CONDITIONER
+50 TON
X
560
=
30
LPG STORAGE TANK
-
X
510
=
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
-
VI.ENT
- --
-:-_,--
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DLIE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
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-TAPPlOVE,
7 ft. 2.7 in. x 9 ft. 7.6
4 ft. 3.2 in. x 7 ft.
11.2 i ..,..
13ft. 11.6 in.x 17ft.
Existing
1/4" = 1'
Dimensions Not Verified
ri
410 e
Apr
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t