2003, 08-19 Permit App: BLD-03-02271 ResidenceAUG 03 2003 14:48 FR
TO 4834966 P.01/03
/O5 sfl
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNI7YDEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509 88-003T
REQUIRED SITE INFORMATION
STREET ADDRESS: - /1-4C1I J Crl'iC�li'�/
t , 590l
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
)1BUILDING PERMIT CI CHANYGE IN USE • CI -GRADING a MANUFACIMI ED HOME
pRELOCAT/ONDOTHER
DS;G* D TENANT
QVVNER C DC l--Li�.S l//ti C D APPLICANT:
PHONE 3-6;53 7- FAX: U6S-4-I.PHONE FAX:
ADDRESS: /U FS -70 Cf es i G-1 ' »€ _ ADDRESS
S-rj&qftt U r,STATE, ZIP CITY, STATE. ZIP
< 0 �� ;
CONTRACTOR: 1 --ZCG G _ Or; ARCHITECT:
PHONE: e-15? --5-67s73 Z FAX: PHONE:
ADDRESS: A-) i SP&e-- 1-t= ADDRESS:
1.1 NA- - CfCr7 t % CITY,.STATE, ZIP
WA ST CONTRACTOR LICENSE# L• Ai 2C 6 -OO 1 ZP5 CONTACT:
FAX:
CITY, STATE, ZIP
1
PERMIT/BUILDING INFORMATION
•.NE11111..
i
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: 2-0 OCCUPANCY GROUP:. 2N0 FLOOR SQ FT: C
BUILDING DIMENSIONS: 1-5X 5-1 CONSTRUCTION TYPE: UNFIN BASEMENT:
C
NUMBER OF STORIES: 1 STRUCTURES ON PROPERTY: FINISHED BASEMENT:
NUMBER of BEDROOMS: 2- CRITICAL AREAS: GARAGE ii• Cl•I1--
30% SLOPES ON PROPERTY: /'la
MAIN FLOOR SQ FT: /05
DATE:
METHOD OFPAYMENT:
D O
CASH CHECK
BAN/KCARD�f'
STAFF:
WSA
1
EMPIRES; _ VINO
AUTHOR/ZED SIGNATURE
HUU LAOJ 14.440 rm
I U 4i7J4bbD r . l'JJ/ VJJ
1 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
Plumbing Permit Application
PRorecr
ADDRESS: e / L/ / l
: rro w
Pyr
USE
OWNER
X
PHONE (Daytime Conrad);
—
MAILING ADDRESS;
1
TO/LETS
(Street)
(city/state)
(ZIP)
CONTRAC.tvit:.
�,,a�
C --, DC c..6- ss i,�
LICENSE S: -
C. • co vv -sip-- z +r s
MAILING ADDRESS:
/(i..SS7C't sC i
S4— eAtiE"
PHONE 1;
LA 44-
crG! -
(street)
(city/state)
(MP)
PLUMBING FIXTURES
1 ETHOD OP
3 CASH
ATR
ANKCARD NUMBER:
UTHORJZED SIGNATURE:
** TOTAL PAGE.03 **
DESCRIPTION
DETAILS
i OF UNITS
X
COST
EQUALS
AMOUNT
1
TO/LETS
WATER CL/SET,BIDETS
1S
X
16
1�
2
URINALS
X
56
3
TUBS
BATH, 5rALLON•SIIEBUILT
-3
X
X
16
S6
-
-
\S
4
SHOWERS (PER TRAP)
5
SINKS
LAYS/BASINS, BAR, FLOOR KITCHEN,
LAUNDRY, tffl TTT, JANITOR, PHOTO, X•
RAY, FOOD. PRIT(CUL1NARY/MEAT
-
J
X
16
-
\ J
6
DISHWASHER
I
X
S6
-
7
CLOTHES WASHER
1
X
66
8
GARBAGE DISPOSAL
1
X
S6
•
(p
9
WATERSOFTENER
X
s6
-
10
FELE= HCC WATER TANK
NOTE IP GAS, SFE MECHANICAL
X
16
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
'
X
56
12
FOUNTAINS, DRINKING
X
S6
-
13
WATER PIPINGIDRAIN. N
WASTE, volt PLUMBING
REVERSAL
INSTALLATION, ALTERATION. REPAIR
REVERSALS
X
ss
-
14
-15
SEWAGE EJECTOR
GRIINDIIL SU) PUMP
X
56
•
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE HIE. +
STEAMER, FROOFEK CARBONATOR
SWAMP COOLER
j
X
$6
-
I
16
CROSS CONNECTION DEVICE
VACUUM BREAKER. CHECK VALVE, AND
R.P.S.PD. FOR: VATS. TANKS, BOILERS
X
X
S6
625
-
•
17
SPRINKLER SYSTEM
18
INTERCEPTORS
_
GREASE TRAP, SANDTRAP,CHEMICAL
HOLDING TANK
X
19
MEDICAL GAS per cadet
NITROUS, OXYGEN
X
96
-
20
MSC PLUMBING FIXTURE
X
S6
-
PAYMENTSUBTOTAL:
�
n CHECK
mown
fit..7
.1
PLUS PROCESSING FEE
535.00
}�
0 •
TOTAL PERMIT FEE DUE:
l 3
ATR
ANKCARD NUMBER:
UTHORJZED SIGNATURE:
** TOTAL PAGE.03 **
RUG 03 2883 1448 FR
Si701Eane
TO 4834966
509-688-003,5 - ?hone
11707 East Sprague Avenue, Suite 106
509-688-0037 - Fax
Spokane yaw, WA 99206
Mechanical Permit Application
PRO CT
ADtRESS: - / Licl 1 S— (CO CA../"../
PERMIT
USE:
OWNE. z.:4A.;•z,.:e- 6,_ 0 •
•
- A,c,
PHONE (Daytime Conta ):
ADDRESS.
,t,. c3 s- (c) c -e T-Gi A.,
s - PC 4,4 A.-- tiLAA Z / 7
(street)
• OR 4 1C0.0:0
(city/state) (ZIP)
CONTRACrom , A .... ..
1.-/-4/1; '...,Z,c. , -
'
4S.E:, • ,
LICENSE t•
• iLigr.j-ic c.7_0 0 i a p
MAILING ADDRESS: - -
/L ' S7O r- sT-e- e•
FUEL BURNING APPLIANCE
LA (...A...
0 .
• cr -Z.) -2
519
(ZIP)
METHOD OF PA
CI CASH
e
Q
1
FUEL atioNING APPUANcs
• OR 4 1C0.0:0
i
X
515
•
3
FUEL BURNING APPLIANCE
> 1004:0
X
519
3
umsrro A/MANCE (ADDMONAL FM
' OR tom=
X
550
-
4
UNL1S1T13 APPLIANCE (ADDITIONAL FEE)
430433
X
511
.....---.......-..—.
5
WED APPUANCE (MEC 116/4 AFIIIS min)
. we 400.0:0
X
130
6
USED APPLIANZE (MEC min. ARM ruing)
,40l0
X00
7
9DIU22/REFRIGERATION
- DM
3
BOILER/RERICERATION
101 • =SI STU
X
SZ1
•
9
,
3011.331/REFRIGERATION
53/ • 14:0/4 STU
X
539
•
10
BOILEMOSIGERATION
031 • 1.751114 STU
X
537•
31
SO LER/IDIFISGERA
•I750MITU
X
12
GAS LOG, CAS INSERT. GAS FIREPLACE
-
0
•
i()
13
RANGE
510
-
14
-
X
510
15
X
510
-
.
16
tan FUEL maim Ayrr-
-
X
510
•
17
GAS MING (ea OuI4)
-
3
X
SI
-
'3
16
DUCT SYSTEM
-
/
X
310•
/0
19
VENTILATING FANS
X
SID
-
20
AZ HANDL�(OONOThi.4ug6zJ•
O20��M
X
512
21
AIR NANDLER (DOES NUC Sub& dacha
)• 10=0 CPU
X
319
•
32
COOLERS
-
X
510•
Z1
1
.
24
'TYPE II HOOD
-
X
330
15
HEAT PUMP=
TON
X
26
AIR COMMONER
34570N
X
550•
V
AIR COMMONER
15-31) TON
X
$15
"
28
AIR CONDITIONER
30.50 TON
X
535
"
ME COM:MOMS!
481 TON
X
960
'
90
LAC STORM= TANX
-
X
910
•
31
WOOD OR nun STOVE/NSW
-
'
X
510
•
32
WOOD STOVE - STANDING
-
.
AL
PLUS PROCESSING ff
535.00
TOTAL PERMIT FEE DUE: i 7,3 —
DATE: EXPIRES
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
EXISTING (AFN 171591C)
20' WIDE EASEMENT
FOR WATERLINE TO
BE VACATED.
LOT 2
\ 20' WIDE NATURAL
TEMPORARY
\ DRAINAGE EASEMENT
0
--v
10' WIDE EASEMENT
FOR UTILITIES
14' WIDE
BORDER
EASEMENT
•6
0
cDC
SS \' Q�� r'0Q'/
, /
/
r2.k
(,nlw„ lcue o \ x
XSTA: 32+00 20.0' L
INSTALL TYPE 1
• CURB INLET
\ EL 2037.03
10' WIDE
EASEMENT
FOR UTILITY
kPPROVED B
cy
14' WIDE
BORDER
EASEMENT
SCALE: 1 "=30'
LOT 1, BLOCK 18
SUMMERFIELD EAST 4th ADD.
4--A9 S cro
ENGINEERS o SURVEYORS
1220 N. HOWARD ST.
SPOKANE. WA 99201
FAX (509) 328-0423
(509) 328-5139
101 TRAIN R0.
LEWISTONt ID 46-83501
FAX (208) 76025
(208) 716-2661