2003, 08-14 Permit App: BLD-03-02232 ResidenceSp�kiine
40:Ailey
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: 509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: 14911 E Crown
ASSESSOR'S TAX PARCEL NUMBER(S): 46354.9050
Lt2 BIk18 Summerfield
LEGAL DISCRIPTION:
PERMIT DESCRIPTION: residential construction
rI BUILDING PERMIT
® RELOCATION
® CHANGE IN IJSE ® GRADING ® MANUFACTURED HOME
® SIGN ® TENANT
® OTHER
OWNER / APPLICANT INFORMATION
DOWNER: Harley C Douglass Inc
PHONE: FAX: 487-9792 509 487-1580 PHONE: FAX:
ADDRESS: 8510 N Crestline Ste A Spokane WA ADDRESS:
® CITY,STATE, ZIP 99205
CONTRACTOR:_ Harley C Douglass Inc ARCHITECT:
® APPLICANT:
PHONE: 509 487 9792 FAX: 509 487-1580 PHONE:
ADDRESS: Same as above
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE # H A R LEC D 110 PE
CITY, STATE, ZIP
FAX:
ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
30% SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK: 35 OCCUPANCY GROUP:
CONSTRUCTION TYPE:
BUILDING DIMENSIONS: 44X38
NUMBER OF STORIES: 2 STRUCTURES ON PROPERTY: 1 FINISHED BASEMENT:
NUMBER of BEDROOMS: 3 CRITICAL AREAS: GARAGE: 400
FLANKING SETBACK: CURRENT PROPERTY SIZE: COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: DECK: 120
REAR SETBACK: CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
Residential
MAIN FLOOR SQ FT: 1358
2N0 FLOOR SQ FT:
952
UNFIN BASEMENT:
DO
Spokane
Valley
1
i� ui cast oprague Avenue, Suite 106
Spokane Valley, WA 99206
r Inspections, call 509-688--0
509-688-0036 - 1'lione
509-688-0037 - Fax
1
Plumbing Permit Application
PROJECT
ADDRESS: 14911 E Crown
DESCRIPTION
PERMIT
USE: Residential Construction
OWNER: Harley C Douglass Inc
X
PHONE (DaytimeContact): 509 487-9792
MAILING ADDRESS:
8510 N Crestline Ste A Spokane, WA 99217
AMOUNT
(street) (city/state)
(ZIP)
CONTRACTOR:, Gold Seal Mech
2
LICENSE /:
GOLDSM 290C4
MAILING ADDRESS:
5524_ East. Boone Spokane, WA
99212
PHONE 1:
URINALS
2
(street) (city/state)
$6
(GIP)
PLUMBING FIXTURES
EXPIRES:
tD NUMBER:
ZED SIGNATURE:
DESCRIPTION
DETAILS
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS •
WATER CLOSET, BIDETS
2
X
$6
-
12.00
2
URINALS
2
X
X
$6
-
-
12.00
3
TUBS
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
2
X
$6
12.00
5
SINKS
LAYS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
3
X
Sb
.,1
-
18.00
_
6
DISHWASHER
1
X
16
-
6.00
7
CLOTHES WASHER
1
X .
$6
-
6.00
B
GARBAGE DISPOSAL
1
X
$6
-
6.00
9
WATER SOF IENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
1
X
' 56
-
6.00
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
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, CI IEMICAL
HOLDING TANK
X
S6
-
19
MEDICAL GAS Per outlet
NITROUS, OXYGEN
X
$8
-
_
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYhLENT
VISA .
CHECK ❑ ❑
iVaS
_ _::. i
SUBTOTAL;
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
EXPIRES:
tD NUMBER:
ZED SIGNATURE:
p(wane
.0.sUalley
�.._._. ....--, ... ,l UvIU7 bbb UUjb t''h0111
�
Spokane Valley, WA 99206 509 -688 -0037 -Fax
For I•ns,p9ctions, call 509-E -0054
Mechanical. Permit Application
PROJECT
ADDRESS: 14911 E Crown
DESCRIPTION OF WORK
PERMIT
USE: Residential Construction
OWNER Harley C Douglass
X
PHONE (Daytitt6onttttl_9792
440,
MAILING ADDRESS:
8510 N Crestline Ste A
Spokane
`1NA 99217
(ZIP)
(street)
(city/state)
co• rrrRACTDancar Mechanical
X
LICENSE /: DANCAM102207
MAILING ADDRESS:
311 N Hodges
Greenacres
PHONE 9:
509 924-9921
WA 99016
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH ❑ CHECK 0 1111111MIM❑ a
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UMTS
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
-
!
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 rating)
> 400,000
X
5100
-
7
BOILER/REFRIGERATION
1-100M BTU
X
515
-
1
BOILER/REFRIGERATION
101- 500M BTU
'X
528
-
9
BOILER/REFRIGERATION
501. 1,000M BTU
X
539
-
10
BORER/REFRIGERATION
1001 -1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
12
GAS LOG, GAS INSERT, GAS FEREPLACE .
-
1
X
510
-
1 0 . V 0
13
RANGE
-
1
X
510
-
10.00
14
DRYER
-
1
X
510
•
10.00
15
FUEL BURNING WATER HEATER
--
1
X
510
-
10 , 00
16
MISC FUEL BURNING APPL.
-
X
510
-
—
17
GAS PIPING (ea. Outlet)
^-
3
X
51
-
3.00
11
DUCT SYSTEMS
-
1
• X
510
-
10.00
19
VENTILATING FANS
-
3
X
510
i -
30.00 -
20
AIR HANDLER (DOES NOT Include ducting)
• OR < 10,000CFM
1
X
512
-
12.00
21
AIR HANDLER (DOES NOT Include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE MOOD
-
X
550
-
24
TYPE II HOOD
-
X
510
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
26
AIR CONDITIONER
}15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
28
AIR CONDITIONER
30-50 TON
X
535
-
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
-
HENTPLUS
,—
iti�35P; ^�_
?
SUBTOTAL:
PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
❑ CASH ❑ CHECK 0 1111111MIM❑ a
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
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0
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CROWN
ROAD
14' WIDE
BORDER
EASEMENT
10' WIDE EASEMENT
FOR UTILITIES
10' WIDE
EASEMENT
FOR WATERMAIN
UO
68.48'
MIMI MM.
PLAT BOUNDARY
SCALE: 1 "=30'
APPROVED B
LOT 6, BLOCK 17
SUMMERFIELD EAST 4th ADD.
ENGINEERS o SURVEYORS
1220 N. HOWARD ST.
SPOKANEW90201
FAX (309) 32A
(509) 328-5139
101 THAW RD.
LENRTON, 10 83301
FAX (208) 748-6823
(208) 746-2861
,1?/('' i f�;-7✓
9306 «i..d rrg.
•
LOT 3 I 4)Fti�
4)
APPRc$'ED BY,
EXISTING (AFN 171591C;)
20' WIDE EASEMENT
FOR WATERLINE TO --t j
BE VACATED. /
10' WIDE E
FOR UTILIT
14'
BORDJ -
EASEMENT -
1
.re1/c.
w5 � ,/ o LOT 1
•T
-9p
SCALE: 1 "= 30'
LOT 2, BLOCK 18
SUMMERFIELD EAST 4th ADD.
i \
MW
ENGINEERS ca SURVEYORS
1240 $. MOWARD St
3►OKA/11. WA 11201
FAX (S01 320-0423
(301) 321-2131
101 1114111 RD.
WEWn70N W 1310,
FAX (20*) 741-0123
(201) 741-4511
1