2003, 12-11 Permit App: BLD-03-03245 ResidencePERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
if 1V:97 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
"mialpimmmimminumeinw
STREET ADDRESS:
ASSESSOR'S TAX TAX PARCEL NUMBER(S):
23;14. YZ- kiS 0;2 B/ 11 frAtikotil retrace_
LEGAL DISCRIPTION:
PERMIT DESCRIPTION:
,15c--3UILDING PERMIT
Q RELOCATION
CI CHANGE IN USE GI GRADING
0 -SIGN Et TENANT
CI MAIVUFACTURED HOME
Et OTHER
OWNER:
PHONE:
(114105EY CONSTRUCTION, hnk
PQ BOX 30792
SPOKANE, WA 99223FAX:
1:1 APPLICANT:
PHONE: FAX:
ADDRESS: ADDRESS:
CITY, STATE, ZIP
CONTRACTOR:
PHONE:
CITY,STATE, ZIP
LINDSEY CONSTRUCTION, IN,.
P.O. BOX 30792
SPOKANE, WA 99303x:
ADDRESS:
7? 1100
tt(e—r013
CITY,.STATE, ZIP
CI ARCHITECT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # Ltlit 19SC-6 totpO ut)
COST OF PROJECT:
CONTACT:
frre..17
PERMIT/BUILDING INFORMATION
30% SLOPES ON PROPERTY:
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP:
BUILDING DIMENSIONS: 61, CONSTRUCTION TYPE:
NUMBER OF STORIES: 1
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK: 2 5
3
REAR SETBACK:
LEFT SETBACK:
Li 7
5 -
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE:
CURRENT SEPTIC USE:
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT: ()()
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT:
GARAGE: 171g tf
COVERED DECK: &7
DECK:
SOokane
1�Valley
11707 Fast Slt ague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Tnspl:ction's, call 509-688-0054
Plumbing Permit Application
PROJECT
ADDRESS:
DESCRIPTION
DETAILS
PERMIT
USE:
OWNER: wri o$e 4065 T
UK.PHONE
(Daytime Contact): T 7q 3,1i a
MAILING ADDRESS:
p ,9o -?c. 30')9
2
s pokoe_ wA- ycizz 3
(street)
/
(city/state) (ZIP)
CONTKWCTUi: ,/1r(),mJ^n's
-
LICENSE 1:
MAILING OADLZ 6 ! 3 1
Vera Az& lila
cjgor7
PHONE 11:90.7 `T P `` o
X
(street)
-
(city/state) (LH )
PLUMBING FIXTURES
METHOD OF
E
D . EXPIRES:
B? '.KC?.PD NUMBER.
A.LTHQRIZED SIGNATURE•
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
/
X
$6
-
2
URINALS
X
$6
-
3
TUBS
/
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
2-
X
$6
-
6
DISHWASHER
l
X
$6
-
7
CLOTHES WASHER
C
X
$6
-
8
GARBAGE DISPOSAL
(
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$/,
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
ASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
b1 LAMER, PROOFER, CARBONATOR,
SWAMP COOLER
3
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
17
SPRINKLER SYS IEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC PLUMBING FIXTURE
X
$6
-
PAYMENT
D CHECK
VISA-.F.�. ,�
SUBTOTAL:
PLUS PROCESSING FEE:
$35.04
■ •
`- • '=� -
TOTAL PERMIT FEE DUE:
D . EXPIRES:
B? '.KC?.PD NUMBER.
A.LTHQRIZED SIGNATURE•
L7T1• Ij�I`
» :ane
.,,0Mt11ey
11707 fop—tague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspecticns, call 509-688-0054
Mechanical Permit Application
PROJECT /
ADDRESS. 3z.,:„S CSS
PERMIT
USE:
OWNER L.. ospi, (ear `n
PHONE (Daytime Contact): 79 3 Y�
MAILING ADDRESS`::''??
fi/3Qx
301 Z SpoJean" 04 g4Pz3
(street)
(city/state) (ZIP)
COLICENSE
r�,�Y'
ei..ferk
8:
MAILING ADDRES'S
M ^.
X
PHONE r
(street)
(city/state) (ZIP)
METHOD OF PA
0 CASH 0 CHECK
DATE. EXPIRES:
BANKCP.RD NUMBER
AUTHORIZE -:D SIGNATURE:
DESCRIPTION OF WORK
a OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,000
!
X
915
2
FUEL BURNING APPLIANCE
> 100,000
X
019
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR < 403,000
X
050
•
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
0100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
• or <400,000
X
050
•
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
9100
•
7
BOILER/REFRIGERATION
1•200M BTU
X
015
•
B
BOILER/REFRIGERATION
101 • 500M BTU
X
12B
-
9
BOILER/REFRIGERAT1ON
501 • 1,000M BTU
X
939
•
10
BOILER/REFRIGERATION
1001 • 1,750M BTU
X
057
-
11
BOILER/REFRIGERATION
•1750M BTU
X
195
•
12
CAS LOG, GAS INSERT, GAS FIREPLACE
-
X
910
-
13
RANGE
-
X
010
•
14
DRYER
-
X
010
•
15
FUEL BURNING WATER HEATER
-
/
X
010
•
16
MISC FUEL BURNING APPL
-
X
010
•
17
GAS PIPING (ea. Outlet)
-
2—
X
91
-
le
DUCT SYSTEMS
-
r
X
910
•
19
VENTILATING FANS
-
X
010
•
20
AIR HANDLER (DOES NOT Include ducting)
• OR < 10,000CFM
X
112
21
AIR HANDLER (DOES NOT Include ducting)
> 10,000 CFM
X
919
22
EVAPORATIVE COOLERS
-
X
910
•
23
TYPE I HOOD
-
X
050
-
24
TYPE U HOOD
-
X
110
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
(
X
012
-
26
AIR CONDMONER
3-15 TON
X
020
•
27
AIR CONDITIONER
15-30 TON
X
02.5
•
28
AIR CONDMONER
30.50 TON
X
835
-
29
AIRCONDTTIONER
•50 TON
X
960
30
LPG STORAGE TANK
-
X
010
•
31
WOOD OR PELLET STOVE/INSERT
-
X
010
-
32
WOOD STOVE • FREE STANDING
-
X
52.5
•
MENT
iif..St- .•.!
SUBTOTAL:
PLUS PROCESSING FEE:
535.00
TOTAL PERMIT FEE DUE:
0 CASH 0 CHECK
DATE. EXPIRES:
BANKCP.RD NUMBER
AUTHORIZE -:D SIGNATURE:
Lindsey's Homes
LINDSEY CONSTRUCTION, INC.
POST OFFICE BOX 30792
SPOKANE, WASHINGTON 99223
Proposed Plot Plan
1306 South Custer Street
South half of Lots I & 2, Block 11 Woodland Terrace Addition
City of Spokane Valley, Spokane County, WA
Scale 1:20/public sewer & water provided by City of Spokane
.210
1
�zs fi
le, like.
LOT COVERAGE CALCUL • •
LOT SIZE: 5�0
GARAGE:
RESIDENCE: 1 008
WALKWAY:
PATIO:
DRIVEWAY:
BALANCE:
DEPT. APPR VED
BY;� PJAL(
DATE: 12�ID�b3
pZF: *Mt- 311-03
IDAHO WASHINGTON
ALASKA