2004, 06-30 Permit App: BLD-04-04792 Residence, Valley
ClIOLQ:AK_AC.
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: IQ\
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit
Relocation 0 Change in Use 0 Grading E Manufactured Home
0 Tenant Improvement E] Fire Safety 0 Other
OWNER/APPLICANT INFORMATION
Owner: Ll eNcISQ)"\I COOSA- ----3=fc, Applicant:
Phone: 90V 1015 Fax: 4443 1013 Phone: Fax:
Address: 1:). O. -60X LO---n2--
bKax-tc4 v \Pc qg 245
State Zip Code
Contractor:
Phone:
Address:
Fax:
City
State Zip Code
WA State Contractor License #:
Address:
City
State Zip Code
0 Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
22 A 5S)
# OF STORIES:
MAIN FLOOW1 . FTG:
flu FLOOR SQ. FTG:
UNFIN*S4nNT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG: *-([
DECK/COV. ATIO SQ. FTG:
00
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
el0k,
# OF BEDROOMS: 2_
TOTAL HABITABLE SPACE:
1M PERNcl§ytIURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? C-eiv\ie pr
Simpolan
4,17alley
:INDSEI CONSTRUCTION, INC.
Project Address: p n any 3n792 Permit Use:
Owner: SPOKANE, WA 99223 Phone (Daytime Contact): `a_P< IDI
Mailing Address:
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
City
State
Zip Code
Contractor. License #: Phone #:
Mailing Address:
Zip Code
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
*OF
UNITS
X
COST
■
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
\
X
$8.00
=
2
URINALS
X
$8.00
=
3
TUBS
1
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
2
X
$6.00
=
PREP/CULINARY/MEAT
6
DISHWASHER
1
X
$6.00
=-
7
7
CLOTHES WASHER
1
X
$6.00
=
8
GARBAGE DISPOSAL
l
X
$8.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: 1F GAS, SEE MECHANICAL
X
$8.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
1
X
$6.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
58.00
=
13
FOUNTAINS, DRINKING
X
$8.00
=
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
3
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR:
VATS, TANKS, BOILERS
X
$8.00
=
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
$8.00
=
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:
<Valley
Project Address:
Owner:
Mailing Address'
LINI)SEl CONSTRUCTION, INC.
P.O. BOX 30792
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:
JI VI\I�IVL,
Phone (Daytime Contact): 5hR l(Y;'>
Contractor. License #:
Mailing Address:
City
State
Phone #:
Zip Code
Cir?
Sta
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
0 OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
1
X
315.00
=
2
FUEL BURNING APPLIANCE
Marathon 100,000
-
"X
$10.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than400000
X
$100.00
=
5
USED APPLIANCE (WSEC min. AFUE •
rating)
Equal to or less than 400,000
X
350.00
=
6
USED APPLIANCE (WSEC min. AFUE
rang)
More than 400 000
X
3100.00
=
7
BOILER REFRIGERATION
1 - 100M BTU
-
X
515.00
8
BOKER/REFRIGERATION
101 - 500M BTU
X
328.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
357.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
395.00
=
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
310.00
=
13
RANGE
X
310.00
=
14
DRYER
X
310.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
18
MISC. FUEL BURNING APPLIANCE
X
$10.00
._
17
GAS PIPING (each outlet)
2-
X
31.00
_
18
DUCT SYSTEMS
1
X
310.00
=
19
VENTILATING FANS
3
X
310.00
=
20
AIR HANDLER (DOES NOT Include ducting)
Equal to or less than 10 000 CFM
,
X
312.00
=
21
AIR HANDLER (DOES NOT Include ducting)
Greater than 10000 CFM
X
319.00
=
22
EVAPORATIVE COOLERS
X
310.00
=
23
TYPE IHOOD
X
350.00
=
24
TYPE II HOOD .
X
510.00 '
.=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON -----
1
I
X
312.00
=
28
AIR CONDmONER
3-15 TON
X
320.00
=
27
AIR CONDITIONER
15-30 TON
X
325.00
=
28
AIR CONDITIONER
30-50 TON
X
335.00
=
29
AIRCONDmONER
More than 50 TON
X
$80.00
=
30
LPG STORAGE TANK
-
X
310.00 .
=
31
WOOD OR PELLET STOVEINSERT
X
310.00
32
WOOD STOVE - FREE STANDING
X
325.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD Y.
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
Proposed Plot Plan
1210 So
City of Spokane Valley
County of Spokane, State of Washington
SCALE 1:20 1 SEWER & WATER PROVIDED BY CITY OF SPOKANE
/.
2712
ADDRESS:
ZONE: UR 3.5
ROAD WIDTH: 60
FRONT: FLANKING
COMMENTS:
REVIEWED BY:
PLANNING DEPT. APPROVED
BYE
DATE:
The site Plan is being submitted for the Purpose of
Obtaining a building permit and is a true and correct
Representation of the proposal. A I known property
Lines/dimensions, curb lines, structures and easements
have been identified. Also indicted are wetlands,
bodies of water, steep slopes or other critical areas.
Lindsey Construction, Inc.
I