2012, 04-30 Permit App: BLD-2012-0512 ResidenceSpokane
Valley
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spokanevallev.orq
•
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION ❑ ADDITION/REMODEL
DECK ❑ OTHER
SITE ADDRESS: ` \c \ \'CtA
El ACCESSORY BUILDING
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION: \_,„\
BUILDING OWNER NAME: \-\,�. Lo\
C
NAME:
ADDRESS:
CITY:
PHONE:
CONTACT NAME: �� r
STATE:
FAX: m'i`l
CELL:
7t-'1, e -•K
ZIP: `:2\-\-\,`--,k
PHONE: FAX:
CONTRACTOR NAME:
CELL:
MAILING ADDRESS:
CITY:
STATE:
ZIP:
PHONE:
FAX:
CELL:
CONTRACTOR LICENSE No.: jtsg, Nt&tXPIRES:
CITY BUSINESS LICENSE NO.:'
DESCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:
\c`4
Dimensions:
1-. ` N19
No. of Stories:
\
Total Habitable
Space: V.Y\,\
Main Floor SQ FT:
\`J 1\
Upper Floor SQ FT:
Unfinished Basement SQ
FT: -
Finished Basement SQ
FT:
Garage SQ FT:
�\
Deck/Covered Patio SQ
FT: ,..
Impervious Surface
Area:
30% Slopes on
Property:
No. of Bedrooms:
Construction Type:
Heat Source: (....p,,
ewe or Septic:
TOTAL COST OF PROJECT: $
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submitted and subsequently approved before this application can be processed.
Signature
c
Date: \ _ \2
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit_=Residential_11-11-11.doc
000-
Spokane
.00 Valley
EV
rermit uenter
11703 E Sfkkx
ve, Suite B-3
Spokane VA 99206
(509)688-0: (509)688-0037
permitcentanevallev.org
Community Development
Plumbing Permit Application
SITE ADDRESS: \ \ \ . \sc P,
PERMIT NUMBER:
ii
PERMIT FEE:
H Commercial Iv( Residential
Building Owner
Name:
Phone: Fax:
Address:
City:
State: Zip:
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact/Project Manager:
Name:
Phone:
❑CASH D CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
Lc(-IZ-5-10
(V1;c1�.
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309. doc
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
"L
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coil, Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas, See Mechanical
if
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH D CHECK 0 VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
Lc(-IZ-5-10
(V1;c1�.
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.orq/ under the quick links for Forms, Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/PlumbingPermitApplication040309. doc
r.��vausia�.
valley°
Community bevelopment
Spokane Valley, WA 99206
(509)688-0 AX: (509)688-0037
permitcent kanevalley.org
Mechanical Permit Applica1 'n
rr,i lvu 1 IN UIVLOE, \.
PERMIT FEE:
Commercial VResidential
SITE ADDRESS: \ \
Building Owner
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact/Project Manager:
Name:
Phone:
#UNITS
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Up to & including 100,000 BTU
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Over 100,000 BTU
DUCT WORK SYSTEM
HEAT PUMP/AIR CONDITIONER
0-3 TON
AIR CONDITIONER
Over 3-15 TON
AIR CONDITIONER
Over 15-30 TON
AIR CONDITIONER
Over 30-50 TON
AIR CONDITIONER
Over 50 TON
GAS WATER HEATER
GAS PIPING SYSTEM (each outlet)
GAS LOG, FIREPLACE, & GAS INSERT
APPLIANCE VENTS INSTALLATION, RELOCATION, REPLACEMENT
REPAIRS OR ADDITIONS
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
0 to 3 hp -100,000 BTU or less
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 3 - 15 hp — 100,001 to 500,000 BTU
Over 15 — 30 hp - 500,001 to 1,000,000 BTU
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 30 hp —1,000,001 to 1,750,000 BTU
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 50 hp — over 1,750,000 BTU
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include ducting)
Each unit up to 10,000 cfm, including ducts
Each unit over 10,000 cfm
EVAPORATIVE COOLERS(other than portables)
VENTILATION AND EXHAUST
VENTILATION AND EXHAUST
Each fan connected to a singe duct
VENTILATION AND EXHAUST
INCINERATORS
Each ventilation system
Each hood served by mechanical exhaust
Installation or relocation of residential
INCINERATORS
Installation or relocation of commercial
APPLIANCES
Range, Clothes WaelitiF tr
UNLISTED APPLIANCES
Under 400,000 BTU- -
UNLISTED APPLIANCES
Over400,000 BTU
HOOD
HOOD
L P STORAGE TANK
Type I
Type II
WOOD OR PELLET STOVE INSERT
WOOD STOVE SYSTEM — FREE STANDING
❑CASH ❑ CHECK 0 VISA 0 MC
CARD #:
EXPIRES:
SIGNATURE
VIN:
http://www.spokarievalley.org/uploads/Community Development/Documents/Forms/Building/MechanicalPermitApplication040309.doc
•
Spokane~
Valley®
•
Target Date sheet
For City Use Only
PLUS Project ? ZZ
Project Address
_70 F kr, c- ,2 r(
11703 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
509.720-5240 ♦ Fax: 509.688.0037 ♦ permitcenter®spokanevalley.org
As part of our on-going commitment to customer service during the review process of your project application, we are
providing you with a TARGET DATE for the initial technical application review. If for any reason we cannot meet
this date, we will contact you with a revised target date.
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your project application will have had its initial technical review. It is
not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
➢ Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on multiple applications and it may be
several days before they can look at your new or revised information.
➢ Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the expertise
for dealing with reviewer comments would be the best choice for the entire review process.
➢ Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date, please feel free to contact us if you haven't heard from us by your
target date. Staff may contact you before the target date if the initial review is complete. By following this procedure, you will
save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required documents, as
indicated on your Pre -Application Checklist have been submitted or have been approved for deferred submittal. This does
not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free from
substantive flaws that would prevent technical staff from completing the technical review once it is started. When this step is
complete, your application will be routed to the appropriate staff and remain in their review queue until it comes up for review.
3. Technical Compliance. Once an application is administratively complete, it is routed to technical staff for compliance review.
Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by phone, fax, email,
or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center. When all sections of the
application are received, a Permit Specialist will process the application and contact the person specified on your application for
permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by the Permit Specialist at
that time.
CD -003 V-7/ 06-21-11 Page 1 of 1