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2003, 04-25 Permit App: BD03-175 ResidenceCITY OF SPOKANE VALLEY SITE INFORMATION Site address: I'3 �' [� t,5 L,,, Parcel number: , 4.4qn2, BUILDING PERMIT No. -- l 7tS7 PROJECT INFORMATION Permit use for: Applicant: D L kj" -e. - Subdivision: f1,4 f ej,s 51 uQopp— 'PG, se� Address: - .Zoning: -.. _3s - Water District: ---Contact: - - - - �---- Owner: �c�,Y��, �c�y lr !icR Ij B�xS-j- Phone #: Address: Project name: City '.. Stated_ Zip Sprinklers ? _ Fire Alarm ? _ Security Alarm ? _ imam Mamma Mammon irm■r■■■■r■M■■■■Marr■rrr■■rr.■rr■■r■mom Mom' ■rr■■rrr■M■■r■■Mrree■memmm■rrmr■mmmr■■� Building Permit Information ■■■■rr■rM■rm■M■r■■■ ■r■rrr■ Contractor ■■rrMr�Mr,.r,r■■■rM■r■rM�r■r■rM■rrr�L■i■c■e■n■s■e ■#E rr■r■■■rrrr■■rrr■r■rmmM■rM■■� Occupancy Group �_ Type of Construction -VAJ Height Stories ( Total Square Feet Category: �_ (1= new, 2=remodel, 3= addition, 4= change of use, 5=tenant improvement, 6=mechanical, 7=plumbing, 8=sign, 9= mobile home, 10=demolition, 11=Other ) Total code value $ A3 i # 4! Permit Fee $ _j3 'Plan Review Fee $ State Surcharge $ S� Surcharge $ Fire Fee $ Planning Fee $ Public Works Fee $ .pa TOTAL FEES $1j p w o4 4",—PVWOUNT PREPAID $ _ 7 U 1 y .O TOTAL DUE $ Ito f 4.O `k ■■rM■r■rr■rM■rrr■■m■■■■■■■r■■■•■rmr■■rMrrMrmr■r■rMrrrr■r■■r■■rrr■■■■■rr■Mr■M■■rr■m■■erM■rM■mrM■M■rr■■■rM■m■■i The issuance of this permit does not imply complete approval for construction not in compliance with the codes and standards. ■■■■■m■■■rr■MEN rM■mrrrrr■■rr■r■■rr■r■■rrrrrr■■■■■mar■■■■■■■rasae■■■■■■r■■m.■rM■■M■■rM■r■r■r■rr■r■rM■rMonsoonal NOTES /CONDITIONS OF APPROVAL ■■■■■M■■■■M■■■■■■■M■■■■M■■■■■■■■■■■M■eMrrrrMMrmMr■■mMr■r■■rrr■rrr■■■■■r■Marr■■■■r■rr■rr■r■■■rrrrr■a■mrr■r■m■l 1 cc to File —1 cc to Permit holder -1 cc to Assessor Issued Date 6T1 OF 11707 E. SPRAGUE, STE 106 Valley SPOKANE VALLEY, W.499206 (509)688-0036 FAX -(509)688-6037 SITE INFORMATION Site Address: Parcel Number: 5aa� 4 02 Subdivision: D kan e n5 55atre P6cc Block: S Lot: Zoning: Water Dist: Owner: O •-� l�(.l rr - E4ce I Cin Address: S po Cz (1 -- Building Inspector: keUi n A&iA - BUILDINGS: 0-1 PROJECT TRANSMITTAL: TRANSMITTAL DATE: PERMIT INFORMATION Permit Number: S p D3,j*' 5` Issue Date: Permit Use:LOS � �Q ��� y_ Applicant: Q� 0� Phone: Contact: Phone: Contractor: D -Ql— Setbacks -Frontad Left: � Right: Rear: ZSR APPROVALS ENGINEERS: Q -n ornn' ,l-. f P l.) /7 -s 9 `f / L11 -1126- L l'-1125 City Of SPOKANE VALLEY PERMIT # D O BUILDING PERMIT APPLICATION —_ Box 1 OWNER `� _ ----- B---� 04 u K Y JOB LOCATION OWNER'S ADDRESS /yPHONE DESCRIBE JOB THIS PROPERTY IS OWNED B..SIN.GLE-/MARRIED i PARTNERSHIP CORP. _________________________ BOX 2 CONTRACTOR'S NAME,f'(�j� PHONE�/02�''-©60 0 CONTRACTOR'S ADDRESS,r%3/3-r%3/3 7' CITY Jam" O frt CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) _________________________________ -------------- -----------=------- ___- BOX 3 CONTACT PERSON OF PROJECTPHONE ADDRESS �� caD�r CITY ZIP BOX 4 SEWER AVAILABILITY __�� S WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST$ EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBEF LEGAL DESCRIPTION — / _ (IF NECESSARY, PLEASE S _IT A SEPARATE CENSUS NUMBER LOT NUMBER AGE WITH THE LEGAL DESCRIPTION) I BOX 7 BUILDING SQUARE FOOTAGE (Existing/ proposed) 1ST FLOOR7 / 2ND FLOOR / 3RD FLOOR / OTHER / BASEMENT FINISHED / BASEMENT UNFINISHED / DECK / GARAGE G Z b CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT. BOX 8 (x) SINGLE FAMILY (x) NEW CONSTRUCTION ( ) MULTIFAMILY (NO.' OF UNITS ) ( ) EXISTING STRUCTURE _ ( ) COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY ,,DOD SQ. FT. ------( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE _ Z 4 Z:_SQ. FT. ____--------- BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. BOX 10 Water Service meter size (if known) Also see BOX 4 I BOX 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public' Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF ,MY-� KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ' 6R ABOVE PREMISES TO PE IV1,�I4E WORK OR WHICH THE APPLICATION IS MADE. OWNER/ AGEN ATE D(OVER) 7 art tIF 04^� S�l�ane ,,,oOValley 11707 East Sprague Avenue, Suite 106 509-688-0036 Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 -Mechanical Permit Application PROJECT PERMIT X ADDRESS: AMOUNT USE: = OR < 100,000 OWNER �/ V7! PHONE (Daytime Contact): cC� MAILING ADDRESS: 2 FUEL BURNING APPLIANCE > 100,000 X $19 = (%l q C1a (street) (city/state) x (ZIP) CO O 4 UNLISTED APPLIANCE (ADDITIONAL FEE) LICENSE #: MAILING ADDRESS: $100 = PHONE k: -2 O• - X $50 = (street) (city/state) > 400,000 (ZEP) METHOD OF PAY] DESCRIPTION OF WORK # OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE = OR < 100,000 X $15 = 2 FUEL BURNING APPLIANCE > 100,000 X $19 = 3 UNLISTED APPLIANCE (ADDITIONAL FEE) - OR < 400,000 x $50 = 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X $100 = 5 USED APPLIANCE (WSEC min. AFUE rating) - or <400,000 X $50 = 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X $100 _ 7 BOILER/REFRIGERATION 1-1004 BTU X $15 8 BOILER/REFRIGERATION 101- 500M BTU X $28 = 9 BOILER/REFRIGERATION 501 -1,000M BTU X $39 = 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 = 11 BOILER/REFRIGERATION +1750M BTU X $95 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE — X $10 13 RANGE — / X $10 = /1111 14 DRYER — X $10 = 15 FUEL BURNING WATER HEATER X $10 f� 16 MISC. FUEL BURNING APPL. — X $10 = 17 GAS PIPING (ea. Outlet) _ x $1 = 18 DUCT SYSTEMS _ X $10 = 0 19 VENTILATING FANS — X $10 = 20 AIR HANDLER (DOES NOT include ducting) = OR < 10,000CFM X $12 = 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X $19 = 22 EVAPORATIVE COOLERS — x $10 = 23 TYPE I HOOD — X $50 = 24 TYPE II HOOD — x $10 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON / x $12 = 26 AIR CONDITIONER 3-15 TON X $20 = 27 AIR CONDITIONER 15-30 TON X $25 = 28 AIR CONDITIONER 30-50 TON X $35 = 29 AIR CONDITIONER +50 TON X $60 = 30 LPG STORAGE TANK — X $10 = 31 WOOD OR PELLET STOVE/INSERT — X $10 32 WOOD STOVE - FREE STANDING — X $25 _ KENT a. V — r;, SUBTOTAL: PLUS PROCESSING FEE:5 TOTAL PERMIT FEE DUE: A9�' ❑ CASH ❑ CHECK U Xamomm u DATE: EX S: BANKCARD NUMBER: AUTHORIZED SIGNATURE: METHOD OF ❑ CASH rrr� n ne ,�o Walley 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax ,For Inspections, call 509-688-0054 Plumbing Permit Application PROJECT DESCRIPTION PERMIT ADDRESS: �l�S 1 h -� USE: OWNER:�� C « r v PHONE (Daytime Contact): MAILING ADDRESS: WATER CLOSET, BIDETSX 7 o �a (street) (city/state) (z ) CO T A OR: l_C�� X LICENSE #: MAILING ADDRESS: PHONE #: , - ©60 0 TUBS X $6 (street) (city/state) (ZIP) PLUMBING FIXTURES DATE: PI S: BANKCARD NUMBER: AUTHORIZED SIGNATURE: / /� DESCRIPTION DETAILS It OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETSX $662L = j 2- 2 URINALS X $6 = 3 TUBS X $6 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X $6 = 6 DISHWASHER / X $6 = 7 CLOTHES WASHER % X $6 = 8 GARBAGE DISPOSAL % X $6 = LP 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 $6 = 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER HOSE BIB, STEAMER, PROOFER, CARBONATOR SWAMP COOLER X $6 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6 = 17 SPRINKLER SYSTEM 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 _ ] CHECK ❑ ❑ _._._._:.__.:.. SUBTOTAL: PLUS PROCESSING FEE: U TOTAL PERMIT FEE DUE: �<, DATE: PI S: BANKCARD NUMBER: AUTHORIZED SIGNATURE: / /� ��� r4c) 17 D i',7 5/1,7 6- j4---ra,r,l 'e, y 4VA 6—