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2004, 06-11 Permit App: BLD-04-04591 Residence1 Spokane 40,,Ualley BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone; (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: \ `ZOO'( Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: Building Permit n Change in Use Relocation n Tenant Improvement 11 Grading Manufactured Home Fire Safety n Other OWNER/APPLICANT INFORMATION Owner: Ltncsej i O n Si Z.nc. Phone: -)(p' IN Fax: 1443 /01 Address: 1, 0, Fix 30102„ °. opf 2 City State Zip Code Contractor: Phone: Address: Fax: City State Zip Code r., Applicant: Phone: Address: Fax: City ❑ Architect: Phone: Address: State Zip Code Fax: City State WA State Contractor License #: Contact: Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMEN5_0§S # OF STORIES: \ MAIN FLOOR To Q. FTG: 2"" FLOOR SQ. FTG: UNFIN BEIjIIgIT SQ. FTG: FINISHED BASEMENT SQ_ FTG: GARAGE SQ. FTG: �Q O DECK/COV. PATIO SQ. FTG: 1O 0 OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: �1(X. # OF BEDROOMS: v-2 � TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPESON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? ' WR Jr . SOlane Project Address: Owner: 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 Contractor: Mailing Address: License #: Permit Use: Phone (Daytime Contact): "IlDi1/47-11CLVAI \net 'City State Phone #: 243 Zip Code Ci 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 X 515.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X 519.00 = 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 X 550.00 = 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 5100.00 = 7 BOILER/REFRIGERATION 1 - 100M BTU X 515.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X 528.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X 539.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X 595.00 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $10.00 = 13 RANGE X $10.00 = 14 DRYER X 510.00 = 15 FUEL BURNING WATER HEATER X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING (each outlet) X $1.00 = 18 DUCT SYSTEMS , X510.00 = 19 VENTILATING FANS . X $10.00 = 20 AIR HANDLER (DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER (DOES NOT include ductin_g) Greater than 10,000 CFM X 519.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD X 310.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON 1 X 512.00 = 26 AIR CONDITIONER 3-15 TON X 520.00 = 27 AIR CONDITIONER 15-30 TON X 525.00 = 28 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X 560.00 = 30 LPG STORAGE TANK X 510.00 = 31 WOOD OR PELLET STOVE/INSERT X 510.00 = 32 WOOD STOVE - FREE STANDING X 525.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK 0 VISA 0 MC CARD #: DATE: SUBTOTAL PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: Zip Code S�kane jUalley PLUMBING 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 Project Address: 12.Def `jC1u' l � � Gi Owner: l.-- nose, Mailing Address: 'w. 3Y1 Contractor: Mailing Address: Permit Use: Phone (Daytime Contact): License #: State Zip Code Phone #: City State BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 = 2 URINALS X $6.00 = 3 TUBS ' X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6.00 = 5 SINKS LAVSIBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT X $6.00 = 6 DISHWASHER ' X $6.00 = 7 CLOTHES WASHER 1 X $6.00 = 8 GARBAGE DISPOSAL I 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 INSTALLATION, 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 ✓j . "1 �J 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 = METHOD OF PAYMENT: ❑ CASH 0 CHECK 0 VISA 0 MASTERCARD DATE: EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code Proposed Plot Plan 1209 So. Custer Street City of Spokane Valley County of Spokane, State of Washington SCALE 1:20 I SEWER & WATER PROVIDED BY CITY OF SPOKANE E4C- !efKlD ZO N ADDRESS: N • Cuirck ZONE: UR 3.5 ROAD WIDTH: 60 FRONT: FLANKING COMMENTS: REVIEWED BY: PLANNING DEPT. APPROVED DATE: g The site Plan is being submitted for the purpose of Obtaining a building permit and is a true and correct Representation of the proposal. All known property Lines/dimensions, curb lines, structures and easements have been identified. Also indicted are wetlands, 5odies of water, steep slopes or other critical areas. Lindsey Construction, Inc.