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2004, 09-10 Permit App: BLD-04-07691 Residencete\m... jaiC e City of 1—Ck r,n ofMCk- 0 Lif' l` � BUILDING PERMIT APPLICATION WORKSHEET kane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 Valid E INFORMATION Street Address: 1 2 Solo-th C y- . Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: ,,Building Permit [] Relocation Lim I ❑ Change in Use ❑ Grading ❑ Tenant Improvement ❑ Fire Safety ❑ Other ❑ Manufactured Home OWNER/APPLICANT INFORMATION Owner: ' c _ Phone: kb ) Dl Fax: Lit -1 D1 Address: 1‘.'-7 a CUJ r ��i�ca Kc rn� Inift Qq21.2, City State Zip Code Contractor: ur =y ('mc\-- Phone: g( -1 tir3 Fax: 14I-1-3- itr5 5 Address: t7 7 Cort State Zip Code WA State Contractor License #: ❑ Applicant: Phone: Address: Fax: City State Zip Code Architect: Phone: Fax: Address: City State Zip Code Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMEN, I,p„N 5 # OF STORIES: MAIN FLOOR 2 SQ. FTG: 461 2' FLOOR SQ. FTG: UNFIN BAgMENNT SQ. FTG: "10 FINISHED BASEMENT SQ. FTG: GARAGE SQ: FTG: r 1, 1,0 DECK/COV. PATIO C 5Q. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: Gt\S # OF BEDROOMS: TOTAL I -I ABIIT BBLLE SPACE: IMPERVAODUS�S FACE AREA: COST OF PROJECT: 3G% SLOPES ON PROPERTY: SEWER OR ON- ITE SEPTIC SYSTEM? {.'"\e1119 V 0/I\M PLUMBING PERMIT APPLICATION grpolane City of Spokane Valley Community Development Department BuildingDivision , V ileY 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Project Address: Permit Use: Owner: Phone (Daytime Contact): Mailing Address: Contractor License #: City State Phone #: Zip Code Mailing Address: City State BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK *OF UNITS X COST m TOTAL. AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X 56.00 2 URINALS X 86.00 3 TUBS X $6,00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X WOO = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILRY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT _ X .... = 6 DISHWASHER 1 X 86.00 7 CLOTHES WASHER 1 X $8.00 8 GARBAGE DISPOSAL 1 X 86.00 9 WATER SOFTENER X $6.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 86.00 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X 86.00 = 13 FOUNTAINS, DRINKING X $8.00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERM1ON, REPAIR, REVERSALS X 88.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 86.00 - 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER 3 X .00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X 86.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 86.00 - 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK DATE: SUBTOTAL 0 VISA 0 MASTERCARD PROCESSING FEE 05.00 EXPIRES: TOTAL. PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code Sri°lane 40,14lley Project Address: Owner: Phone (Daytime Contact): Mailing Address: MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Permit Use: Contractor: Mai ing Address: License #: City State Phone* Zip Code C State AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I X $15.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 = 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 X $50.00 = 4 UNLISTED APPLIANCE (Additional Fee) More than 400 000 X $100.00 = 5 USED APPLIANCE (WSEC min. AFUE rating) Equal to or less than 400,000 X $50.00 = 6 USED APPLIANCE (WSEC min. AFUE rating) More than 400,000 X $100.00 = 7 BOILER/REFRIGERATION 1 - 100M BTU X $15.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $10.00 = 13 RANGE X $10.00 = 14 DRYER X $10.00 = 15 FUEL BURNING WATER HEATER ' X $10.00 = 16 MISC. FUEL BURNING APPLIANCE�� X $10.00 = 17 GAS PIPING (each outlet) 2. x $1.00 = 18 DUCT SYSTEMS 1 X $10.00 = 19 VENTILATING FANS 3 X $10.00 = 20 AIR HANDLER (DOES NOT indude ducting) Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER (DOES NOT include ducting) Greater than 10,000 CFM X $19.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD X $10.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON ) X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 = 28 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X $80.00 = 30 LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 = 32 WOOD STOVE - FREE STANDING X $25.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK 0 VISA 1:1MC CARD #: DATE: SUBTOTAL PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: Zip Code