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2004, 10-19 Permit App: BLD-04-07960 Remodel20 ' 3OHd GMAE6 S;00vaiiey 20:60 17002 61 100 BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division 91707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: G1 S , �� S �� SQo k�-. e ►�J�[Q I �l "LJ fz4 Assessor's Tax Parcel Number(s): r -i - 2 2- S 0�`�. Le al Description: t:c. L)n Legal PERMIT DESCRIPTION: Building Permit ❑ Change in Use ❑ Grading ❑ ❑ MMtatneur Manufactured Home Relocation ❑ Tenant improvement ❑ Fire Safety OWNER/APPLICANT INFORMATION �- ❑ Owner. I � `iz C',0"1 e-- E] Applicant:� fJ`'� 8f/ Phone:82-175 _Fax: Phone: Address: c) —6 Address: tl?S n e— Ci State ode C state Zip Code ❑ Contractor: k \ phi -e, 1 enc-- Phone: 21L 6 Fax: S"J -2q 8 F ❑ Architect: Phone: ,_ Fax: Address: eZ o v AL-11Address: -S,00 ICd►rQ_ LAA - �_ �� City state Zip Code City state Zip Code' WA State Contractor License #:A1 (P % Ob -7 ?p kr\ Contact: EIGHT TOREW AIN F-OOR TO SO. FTG: WISHED BASEMENT SO. FTG: N4V —4 CCUPANCY GROUP:� OF BEDROOMS: OST OF PROJECT: PERMft/BUILDING INFORMATION SO. FTG: GARAGE SO. # OF STORIES: UNFIN BASEMENT SQ. FIG' d DECKICOV. PATIO StI. FTG: N TYPE: HEAT AL HABITAB ON PROPLRTY: ON-SITE E0 3E)Vd 30Idd0 NO1dwno 6ZEL9Z6 00:60 1700Z/6T/01 10/19/2004 UJ: UJ Width: Manufacturer: Previous Address: Proposcd Use: _ yLb tjztj uurir i U1 v[ i ivy A - MANUFACTURED,F SAE Length:_ Year RELOCATION FIRE SAFETY Pit Set: Fire Sprinkler: # of Heads:ire Alarm: _ Paint Booth: Tent: Fireworks Display: Blasting: DatelTime: Valuation: Above/Un ground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Phone: Fax: Address: city state zip Inspector: Phone: Fax: Address: city state zlp y j SPECIAL INSPECTIONS ❑ BOLTING U CONCRETE Firm Name: Inspector(s): ❑ REINFORCEMENT Phone: Fax: ❑ WELDING DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling in/will be served by potable water. 2) Ownership of this City of Spokane Valley 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 Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit inure to the property owner. Print Name Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check Bankcard #: ❑ Mastercard ❑ VISA ❑ Other Expires: — VIN#: Authorlxod Signature: - OCT 19 2004 09:05 9267329 PAGE.01 Z0'30dd 6ZEL9Z6 i.0:bI0 vent o /...Au PLUMBING PERMIT APPLICATION • SOY City of Spokane Valley Community Development Department pt3ul/dlr►gDivisTon 0,�e 11707 E.Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Pitons: (509)688-0036;Fax: (509)688-0037 • FOR INSPECTIONS, CALL(509)688-0054 Project Address: (Li 17 5 Davd S Permit Use: Owner, C Q 0 c�i e-'• Phone (Daytime Contact): I 1 1St Mailing Address: S C.,.`^ ■ S PO Q t) i( 2 •A City State Zip Code Contractor, ,A\\Q Le, License#: A I I 'k \4'o77P,Phone#: Mailing Address; oO A( ,, ► ' o. _ k• ....4 e-- 1� it 2 Z City -tate Zip Code - - #Of - ToTAL-- DeSCRIPTION OF WORK UNITS X COST • AMOUNY i TOILETS WATER CLOSET,BIDETS _ / X is-00 s 41 (p0 2 URINALS x woo ■ 3 TUBS . , X te-00 . 4 SHOWERS PER TRAM BATH,STALL,ON-SITE BUILT I X $6.00 = A ' 5 SINKS UMIBA•INS,BAR,FLOOR. , KITCHEN,LAUNDRY,UTILITY, I X $ .o0 = Go JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY(MEAT B DISHWASHER X S6.00 - 7 CLOTHES WASHER X Se.00 B GARBAGE DISPOSAL , X 58.00 - 0 WATER SOFTENER . X $8.00 -= 10 ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X 38•00 0 . 41 FLOOR DRAINS 'AREA,CSAASS,COIL,TRENCH, X $8.00 = _ CONDENSATE 12 , ROOF DRAINS/OVERFLOW DRAINS X se.00 = , is FOUNTAINS.DRINKING . . . X $8.00 = 14 WATER PIPIKGFD RAIN-IN WASTE. INSTALLATION,ALTERATION, X 38.00 VENT, PWMBIN©,REVERSAL RtPAI .REVERSALS 15 SEWAGE EJECTOR GRINDER,SLAW MAP X $6.00 = 18 WATER USING DEVICE ICE AMIOR COFFEE MAKER, HOSE BIB,STEAMER.PROOFER. X $6.00 - CARBONATOR.SWAMP COOLER , I? GROSS CONNECTION DEVICE vgcuUM BREAKER.CHEEK .• VALVE.ANDR.P.B.P.D.FOFr X x-00 • VATS,TANKS,BOILERS ._ 18 INTERCEPfr)RS • GREASE TRAP.SAND TRAP, X $6.00 = • CHEMICAL HOLDING TANK 19 MEDICAL GAS two outlet) NITROUS OXYGEN X $8.00 z 20 MISCELLANEOUS PLUMBING FIXTURE • © SB.00 = • METHOD OF PAYMENT: SUBTOTAL ❑ CASH D CHECK 0 VISA ❑ MASTERCARD PROCESSINGfEE $35.00 DATE: EXPIRE& TO$AI,PQwan'FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Z0 30ad 30Idd0 NOldW00 6ZEL9Z6 0060 b00Z/6T/0T 10/19/2004 09:03 9257329 CUMPTON OFFICE PAGE 02 '., oill MECHANICAL PERMIT APPLICATION SPakane City of Spokane Valley Corninunit) Development Department BufldingDivislon VitI 11707 E.Sprague Avenue, Suite 1r 4, Spokane Valley, WA 992b--.../ Phone. (509)688-0036;Fax: (509) 688-0037 FOR INSPECT/ONS, CALL(509) 588-0054 Project Addre : Permit Use: Owner, Phone(Daytime Contact): 2" 12/ '5_S • Mailing Address: . Cry State , Zip Code Contractor: License#: Phone*. Mailing Address: CityStab. Zip Code • R OF TOTAL DCSCRfPT10NOFWORK UN/TS X COST - AMOUNT I 1 FUEL BURNING APPLIANCE ,6E• }o orteeathan 100,000 X 515.00 ---'-2- ttBL`E23Rt(IPSiAPPIrtaNCE. V r.. . 'tare r. u.. X 516.0Q 3 1 UNLUSTEDAPPLWNCE(AddAtonal Feel , • . ;•or teas than 400,000 X 550.00 4 UNLISTED APPLIANCE(Additional Fee) Mo - In 400,000 X 100,00 - USED APPLIANCE(WSEC n tr.AFUE s rev Eq_uzl to act-. , , 400,000 X $SO.00 II USED APPLIANCE(WSEC min.AFUE 0 _t rd4re51} More trail 400, •• X $100.00 7 I BOILER/REFRIGERATION 1-100M BTU • , X S1ai00 u 8 , BOIIERVREFRIQERAT1OW 101-5OOM RTU X $28.00 • n Pt) FR/RFFPIC'.FRATtON .601-1,00C1.t BTU X ;39.00 . 10 BOILERIREFR GERATION 1 001-1,750M BTU X $57.00 11 BOtLERYREFRiGERAT'ION MoleIRan 1,760M BTU _ X 595.00 a - 1 12 1 CAS LOG,GAS INSERT,GAS FIREPLA : X $10.00 ,.� 13 RANGE X $10.00 14 DRYERX $10.00 15 FUEL BURNING WATER HEATER 117 I, $10.00 • 16 MIGC.FUEL BURNING APrLtAt1oCX, $10.04 i 17 GAS PIPING(each outlat) X $1,00 \\' ‘ ‘ , S8 DUCT SYSTEMS x 14.00 I a 19 VENT1LATINGFANS X '•0.00 ^ 20 AIR HANDLER(pOES NOT Include du..nq) Equal to or leas than 10 000 CFM X '00 m / 21 AIR HANDLER @GES NOT includes d ag) Greater than 10,000 CFM X Lie.'0 a 22 EVAPORATNE COOLERS X $10.0. Z3 TYPE t HOOD X F50.00 z 24 TYPE It HOOD X S10.00 NEAT Pt IMP/AIR CONO TION'ERtSs Tr1N X S1 7 M AIR CONgtTtONER 3-15 TON Is X $20.00 -11 AIRCt1wrno ER 15 3C TO X $25.00 20 ' AIR CONDITIONER 30.:53 TON el $35.00 20• AIR CONDITIONER More than 60 TON X 580.00 30 LPG STORAGE TANKX $10.00 `al WOOD OR PELLET STOVEIINSERT X $10.00 n 22 k WaOTI TTIVF.FPEE.STANCITWC X 625.00 . METHOD OF PAYMENT: _ SUBTOTAL ❑CASH ❑CHECK 0 VISA ID MC DATE: PROCESSING FEE $35.00 CARD te EXPCRES. TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: I OCT 19 2004 09.05 92E7329 PAGE.02