2004, 10-06 Permit App: BLD-04-07856 Finish BasementSan
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4,00sky
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
(h� Q,. 11707 E. Sprague Avenue, Suite 106
rift' p') Spokane Valley, WA 99206
�` :
Y. Phone: (509) 688-0036; Fax: (509) 688-0037
\
REQUIRED SITE INFORMATION
Street Address: /3 C1) . t ve ry2.e
Assessor's Tax Parcel Number(s):
Legal Description: 1
d�QSPrn resod e -I
PERMIT DESCRIPTION:
❑ Building Permit
❑ Relocation
❑ Change in Use LI Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
fir,
❑ Owner: /-QA,l„(ti.
Phone: 99T, 77 L
�'J�,` Address:1-;crk Late
.l3a'f
ill 14Er(aWlt 111Applicant:
ec
City 1
?5 Fax: Phone:a
NLiberl Le Rd ItI?3 Address:
�R Woi q
Fax:
Contractor:
Phone:
State Zip Code
Address:
Fax:
City
State
WA State Contractor License #:
City State Zip Code
❑ Architect:
Phone: Fax:
Address:
Zip Code City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2NO FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
/5-
sFINISHED
FINISHEDBASEMENT sq..FTG:
y83
GARAGE SQ. FTG:
DECK/GOV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE: FA 9a5
# OF BEDROOMS: J
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? Ser
Saliolane
tonalley
Project Address: 1313 ( y v E✓e r3Y'e.e n
Owner: Laura G-- c I
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuitdingDivision
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: baseitietewtadJ
Mailing Address:
13x4 N LiHer'iy(iike Ret 4t73
Contractor.
Mailing Address:
Phone (Daytime Contact): 6-69* M-7575"
L I� e r%ty LaL.e Wyg P 20l
City State Zip Code
License #: Phone #:
City
State
BANKCARD NUMBER
AUTHORIZED SIGNATURE: -
Zip Code
DESCRIPTION OF WORK
tt OF -
UNITS
X
COST
-
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET BIDETS
1
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH STALL, ONSITE BUILT
1
X
98.00
=
5
SINKS
�1/1IBASINS, BAR FLOOR,
3,
X
56.00
=
KITCHEN DRY` UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=-1
6
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS -
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
-
X
Sem
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE, _
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICEAN/OR COFFEE MAKER
HOSE BIB, STEAMER. PROOFER
CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK
VALVE, ANDRP.BP.D. FOR
VATS, TANKS, BOILERS
X
_ 56.00
=
18
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
*6.00
=
INTERCEP FURS
19
MEDICAL GAS (per outlet) -
NITROUS, OXYGEN
X
56.00
=
20
M*SCELtANEOtJS PLUMI3tNG FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: -
Zip Code
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
Project Address: Permit Use:
Owner. Phone (Daytime Contact):
Mailing Address:
Contractor.
Mailing Address:
License #:
City
State
Phone #: -
. Zip Code
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
0 OF
UNITS
X
COST
=
,
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
515.00
13
`
2--FUEt8URNINGAPPtt4NCE
More Nan 100,000
X
519.00
3
UNLISTED APPLIANCE (Add &oral Fee)
Equal to or less than 400000
X
550.00
4
UNLISTED APPLIANCE (Additional Fee)
- More than 400 000
X
5100.00
5
USED APPLIANCE (WSEC min. AFUE
rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC mm. AFUE
rating)
More than400000
X
5100.00
7
BOILER/REFRIGERATION
1 ,100M STU •
X
515.00
8
BOILER/REFRIGERATION
101 • 500M BTU
X
$26.00
9
BOtLEEVREFRIGERAT1ON
501 -1,000M BTU
X
539.00
r
10
BOILER/REFRIGERATION
1 001 2l 750M BTU
_
X
$57.00
11
BOILER/REFRIGERATION -
-. More than 1 750M BTU
-
X
-- 185.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
=
13
RANGE
X
510.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
$10.00
=
-_
16
MISC. FUEL BURNING APPLIANCE
-
X
$10.00
=
17
GAS PIPING (each outlet)
t
X
$1.00
16
18
DUCT SYSTEMS
-r-
X
510.00
=19
_
VENTILATING FANS
1
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
-
X
$1200
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
519.00
22
EVAPORATIVE COOLERS
X
510.00
23
TYPE I HOOD
X'
550.00
=
24
TYPE It HOOD
X
$10.00
25
HEAT PUMPfA92 CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
520.00
27
AIR CONDITIONER
15-30TON_
X
725.00
=
28
AIR CONDITIONER
i 30-50TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
-
32
WOOD STOVE - FREE STANDING
X
525.00
METHOD OF PAYMENT:
CICASH 0 CHECK 0 VISA 0 MC '
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
,
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