2004, 07-12 Permit App: BLD-04-07166 Residence*Wane
.00Valley
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: 2 2- ' V / /]a s C
Assessor's Tax Parcel Number(s): 2 S J- Lig N C/ 7
Legal Description: {'/'J d,ei,>,,v f r, s2 -c / Sr Lor b g, J k 3
PERMIT DESCRIPTION:
Building Permit
Relocation
❑ Change in Use . ❑ Grading
❑ Tenant Improvement ❑ Fire Safet
❑ Manufactured Home
Pei W E
OWNER/APPLICANT INFORMAT
D
❑ zCwner: eip a ,'v k , PA- s. -e ❑ Applicarto
/ Phone: g G - c/7S3 Fax: Phone:
Address: 30 , o S A's tj- 6 Z- Address:
000,C 1/4//ew 4- . 9'06
City State Zip Code City
VContractor: w Pi e✓�-- a /c551_ ❑ Architect:
Phone: _ Fax: Phone:
Address: Address:
_LUI 12 7004
State
Zip Code
Fax:
City State Zip Code City - State Zip Code
WA State Contractor License #:
Contact: r/ / w .S% EBL 4J 9 25- -/6 9$
Zl oJ, S2,o e,2 u is o/L
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK3 D r
DIMENSIONS: 5,7- / ��
# OF STORI9:
MAIN FLOOR TO SQ. :
//L0
2"" FLOOR SQ.
s
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT Q. FTG:
-27/4-
GARAGE SQ: FT
7d
DECKJCOV. PATIO SQ. FTG:
N/pt
OCCUPANCY GROUP:
SG ice---
CONSTRUCTION TYPE:HEAT
WoocV G,e6,ne�
SOURCE:
9,¢S
# OF. BEDROOMS:
1
TOTAL HABITABLE SPACE:
2 2 7 V
IMPERVIOUS SURFACE AREA:
----
COST OF PROJECT:
i/Coaa
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? -?-
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: ; ''I ;l `I (.- Phone: Fax:
Address:
it
City State
Inspector: Phone: Fax:
Address:
•
City
State
Zip
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
❑ WELDING
Phone: Fax:
Inspector(s):
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 is/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 resultingsdevelopment�rights'granted by any issued permit
inure to the property owner.
(J/�//s.✓ � .S "rif -e_ Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
Print Name
❑ Cash ❑ Check El Mastercard El VISA ❑ Other
Bankcard #:
Authorized Signature:
Expires:
VIN#:
4,Valley
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:
Project Address: ;2'Z /7114
M_Sk
Owner: GS 2 / 4^' , 4S I: -a
Mailing Address: -3 o / o ,C-' P, N .er dd to
S,o G 6,i i+- 9C-2-0 6 . City State
Contractor: License #: Phone #:
Mai ing Address:
2 -
Phone (Daytime Contact):
Zip Code
State
AUTHORIZED SIGNATURE:
Zip Code
3 Z
b
Ny
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100 000
X
515.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
/
X
$19.00
=
/'
/7 -
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
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
rating)
More than 400 000
X
5100.00
_-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
357.00
=
11
BOILER/REFRIGERATION
Mare than 1,750M BTU
X
595.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
/
X "
510.00
=
/0
13
RANGE
X
510.00
=
'
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
3
x
$1.00
=
.3 -
18
DUCT SYSTEMS
/
X
$10.00
=
-
----
19
19/
VENTILATING FANS
17/
X
510.00
=
�/0
12
20
AIR HANDLER (DOES NOT indude ducting)
Equal to or less than 10,000 CFM
X
512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
/
X
$19.00
=
/ 9 -:
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE 1 HOOD
X
550.00
=
24
TYPE II HOOD
. /
X
510.00
=
/0
25
HEAT PUMP/AIRCONDITIONER
03 TON
X
512.00
26
AIR CONDITIONER
3-15 TON
/
X
320.00
=
02 0
27
AIR CONDITIONER
15-30 TON
X
32500
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
360.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
325.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
raon a
DATE:
SUBTOTAL
PO
PROCESSING FEE
535.00
EXPIRES'
TOTAL PERMIT FEE DUE:
/ 7,5
AUTHORIZED SIGNATURE:
Zip Code
3 Z
b
Ny
Spokane
jMalley
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
Project Address: 09,1 /1-/ 61--5 Permit Use:
Owner: go , :-✓ � A-Sk--e-
Mailing Address: So / 0
6
Phone (Daytime Contact):
City State
Contractor: 0/A.),} e -,L &COet2_ License #: 77//9- Phone #:
Mailing Address: %o 6390 t3 o
,O -e, Coo&
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
v
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
56.00
=
fd
2
URINALS
X
$6.00
=
3
TUBS
.2---
X
$8.00
=
/
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
/
f�
X
$8.00
=
36 "
6
DISHWASHER
( /
X
56.00
=
/2
7
CLOTHES WASHER
/
X
56.00
=
//
b
8
GARBAGE DISPOSAL
(
X
58 00
=
(J
9
WATER SOFTENER
-
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
58.00
=
13
FOUNTAINS, DRINKING
X
58.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
/
X
56.00
=
/
L,
!!!///
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND RP.B.P.D. FOR
VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per oat)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE EXPIRES:
SUBTOTAL
141 r
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
/.1-5::D 0
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
Parcel: 45251.1106
Owner: SULLIVAN HOMES, INC
CoOwner:
Owner Address
3004 N SULLIVAN RD STE A SPOKANE WA 99216
Site Address
2214 S DUSK VERADALE
Legal Description
MORNINGSIDE PHASE I, P.U.D. LT 6 BLK
3
Notice: This is not a legal document. Data depicted on this map is general 8 subject to constant revision. It is intended
for reference use only. Legal documents should be obtained from the appropriate agency.
r/ IIS
Zig c f~sk
PLANT !G DEPT. APPROVED
BY;
DATE 7
Obtaining a builslte plan ding subtitled tor the purpose of
nntation lcon9 permit and is a true and cornet
Mies/dimensions. curb lines. strructur ll kande
bate been identified. Also red end edea
bodies of w:: r. steep a so indketad are wareas.
. ,,_._�.__...... criticalcriticall areae.
Signed:
Day b2_0�K
%y 'dor
fi/ ,2600
5rtneI N6M�- H ih
e Qs� c- Sp rc
1.1202
11404'.
1.1010
Mas Production Date: Asril 21 2003
RAP HI C I NF ORMAT I ON SYSTEMS
R44E.W.M.
ated Map
(CONTROL
OFFICE PURPOSES ONLY
NOTICE:
The information shown on this map is compiled
from various sources, and is not warranted as
to its accuracy. Users are reminded that
Legal Documents must be obtained from the
appropriate agency.
F
SCALE. ,1111
200 100 0 100 200 OP
26
24
y„„
NW
sw
SE
36
30
y4-/ NEyt