2004, 04-30 Permit App: BLD-04-04241 Basement AdditionSpoUTIOF
kane
Valley
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: 1505 5, [l/C/ ffee4 ped
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: f11/5 -4/4g /?aCent eA -
Building Permit
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: 7&/Y /570,/'l (tee We_cec38)
E%an9r(t. *jhone: r red/9/ Fax: 72Y6/9/
cep/28"0-Address: /505 5, 6iiery/ee4,fes(
o63�y S3M2n e lr; 2r i4O4 99037
City J State Zip Code City State Zip Code
❑ Contractor: cJw4er ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
Applicant:
Phone:
Address:
Fax:
City
State
WA State Contractor License #:
Zip Code
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
1/20
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
Spb�kane
#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
Project Address: / SOS S, L Verg/'een £( Permit Use:
Phone (Daytime Contact):
Owner: 7 ,-/d/5/sa,n1
Mailing Address' /5'o,S' S r✓c7reen
Contractor: Owner
Mailing Address:
Re/
License #:
City
State
Phone #:
Zip Code
Ci
State Zip Code
-
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000 -
X
315.00
=
/5i%D
2
FUEL BURNING APPLIANCE
More than 100,000
X
519.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
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
550.00
=
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
328.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
539.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
595.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
310.00
=
13
RANGE
X
510.00
=
14
DRYER
X
310.00
r-
15
15
FUEL BURNING WATER HEATER
X
$10.00
=
18
MISC. FUEL BURNING APPLIANCE
ti
X
$10.00
=
17
GAS PIPING (each outlet)
9
X
31.00
=
1. &0
18
DUCT SYSTEMS
I
X
$10.00
=
/a OD
19
VENTILATING FANS
X
$1000
=
20
AIR HANDLER (DOES NOT include 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
519.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
X
$10.00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON•
X
512.00
=
28
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
525.00
=
28
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER
. More than 50 TON
X
580.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
32
WOOD STOVE - FREE STANDING
X
525.00
=
METHOD OF PAYMENT:
0 CASH ❑ CHECK ❑ VISA CI
CARD #.
DATE:
SUBTOTAL
PROCESSING FEE
\
EXPIRES:
TOTAL PERMIT FEE DUE:
7i.
AUTHORIZED SIGNATURE:
S�"�`�kan' e�
Valley
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: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City
Q State Zip Code
Contractor: Ba990145 4 t` T 1744114Q License #: Phone #: 92 S0e779
Mailing Address: J -
State
City
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
/
X
$6.00
=
(2 . co
2
URINALS
X
58.00
=
3
TUBS -
/
X
$6.00
=
i:o/✓
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
/
X
56.00
=
it%C
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
/
X
58.00
=
6: a.%.
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
58.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
/
X
58.00
=
/OO
(�
12
ROOF DRAINS/OVERFLOW DRAINS
X
$8.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
58.00
=ikie
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
1
X
58.00
=
/
(j , OO
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
$8.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR:
VATS, TANKS, BOILERS
X
$8.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK .
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
•
X
58.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK 0 VISA 0 MASTERCARD
DATE: EXPIRES.
SUBTOTAL
PROCESSING FEE
53 0
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code