2011, 08-04 Permit App: 11002311 Solar PanelsProject Number: 11002311 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/4/2011 Page 1 of 2
Project Information:
Permit Use: SOLAR HEATING PANELS ON ROOF Contact: KURTZ, SCOTT A
Address: 1621 N CENTER RD
C - S - Z: SPOKANE VALLEY, WA 99212
Setbacks: Front Left: Right: Rear: Phone: (509) 951-1903
Group Name:
Site Information: Project Name:
Plat Key: Name: BRADLEY HEIGHTS District: Nort
Parcel Number: 45073.2704 Block: 1
SiteAddress: 1621 N CENTER RD
Location:: CSV
Lot: 4
Owner: Name: KURTZ, SCOTT A
Address: 1621 N CENTER RD
SPOKANE VALLEY, WA 99212
Zoning: R-4 SF Res Urban District
Water District: 101 SPO CO WATER DIST#3B Hold: ❑
Area: 10,232 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review
Released By:,
Originally Released: 8/3/2011 By: tmelbourn
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
l&2 FAMILY R-3 VB PLAN 0 $350.00 0 $350.00
REVIEW
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 0 $350.00 0 $350.00
Units Unit Desc
I SELECT
I SELECT
I SELECT
Operator: JD Printed By: JD
Fee Amount
$69.25
$4.50
$27.70
Permit Total Fees: $101.45
Print Date: 8/4/2011
2
iJ
Project Number: 11002311 Inv: 1
Notes: ,
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 8/4/2011 Page 2 of 2
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit
$101.45 $101.45 $27.70 $73.75
$101.45 $101.45
$27.70 $73.75
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD
Print Date: 8/4/2011
Spokane
_#Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 686-0036
Fax: (509) 688-0037
permitcenter(sookanevallev.orq
(Staff Use Dnly3
PERMIT NUMBER:—
PERMIT FEE:
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
El NEW CONSTRUCTION
Q DECK '"
SITE ADDRESS: i�WZ
ASSESSORS PARCEL NO.:
Q ADDITION/REMODEL
OTHER
n1 r.EnYTEL RN
LEGAL DESCRIPTION:
0 ACCESSORY BUILDING
BUILDING OWNER NAME:
NAME:
Clot—
ADDRESS:
lo
ADDRESS:
!L 2-f rJ C_EAPTEAZ GC
CITY: Sc'�/'rr„
KA -4 VA-tA-L STATE: i t)A
-�q
S qt g 1 5-- (0L3 9 FAx:
PHONE:
CONTACT NAME:
ZIP:
CELL:
PHONE:
FAX: CELL:
CONTRACTOR NAME:
MAILING ADDRESS:
CITY:
STATE: ZIPS
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
IrJsTAt.0 souk_ 4EATItJ9 PA -of LS Loo -F- -Tho I -/c Tv(a
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
Dimensions:
No. of Stories:
Total Habitable
Space:
Main Floor SQ FT:
Upper Floor SQ FT:
Unfinished Basement SQ
FT:
Finished Basement 5Q
FT:
Garage SQ FT:
Deck/Covered Patio SQ
FT:
Impervious Surface
Area:
300/0 Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source:
Sewer or Septic:
TOTAL COST OF PROJECT: $ 3,52)o0 60 -
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction or on a dwelling, the dwelling is/will
be served by potable water. 2) Ownership of this City of Spokane Wiley permit Inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Developme code. Referenced codes are a ilable for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is n [ permit or approval for a y lation of f deral, state or local laws, codes or ordinances. 6) Plans or additional
information may be requir d�t� be sub ..nd subs ju ntly approv d before this application can be processed.
Signature
Date: S — 3 — ZED/ l
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_ _Residential_ 11-11-11.doc
Spokan
4Ualley•
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perrniteenter(? sookanevallev.ore
Community Development
Plumbing Permit Application
PERMIT NUMBER: ((— r43 (1
PERMIT FEE:
n CommercialResidential
SITE ADDRESS: 'Q-,7.1 k1 l 7111/4J—E-42. Q_h
Building Owner ••
�5
,%phones -0,7_5 /� -�p�7
Name: 1 I i— IW c z_ %s--_ 0,
`_--ct �1 9 p
Address: i p 2_i L 1 2.(T` pm City: � 1(.7:40LVrta-ET tate: (A) f+ Zip: 2_( Z
Contractor .
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case Coil Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
sa (44- vdATV_ Midi
-Ls' 6e -lett lac))
1
UCASH U CHECK U VISA U MC
Card#
SIGNATURE:
EXPIRES:
VIN:
P:\Community Development \02 Administration\03 Forms - Official Versions\Permit Center\Plumbing Permit Application 04-03-09 dg.doc