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2004, 02-17 Permit App: BLD-04-03565 Remodel*Wane �► 4/.1/alley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Job Address: Description: Subdivision: Owner: Applicant: Address: Contractor: Address: THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit RESIDENTIAL ADDITION/REMODEL 222 S FLORA RD GREENACRES WA 99016 18 X 18 KITCHEN & DINING ROOM ADDITION W/14 X 18 UNFINISHED BASEMENT AND 5 X 24 BEDROOM CLOSED ADDITION ON CRAWL SPACE (THIS PERMIT INCLUDES NEW KITCHEN PLUMBING) Lot: Blk: ROYER, RICHARD B & ALISSIA A Application #: BLD -04-03565 Applied: Issued: Expires: Parcel No: 45241.9102 ROYER, RICHARD B & ALISSIA A Phone: (509) 326-4195 222 S FLORA RD GREENACRES, WA 99016 Phone: Lic No: Zoning: 02/17/2004 02/17/2004 08/15/2004 General Information: VALUATION REROOF BUILDING HEIGHT TO PEAK # OF STORIES FRONT SETBACK REAR SETBACK LEFT SETBACK RIGHT SETBACK OCCUPANCY GROUP CONSTRUCTION TYPE STRUCTURES ON PROPERTY CURRENT PROPERTY SIZE SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY SINKS DISHWASHER GARBAGE DISPOSAL 36938 N <15 1 EXISTING 100+ 15 5 r-3 5-w 1 75 X 300 yes no 1 1 1 Fees: PLAN CHECK FEE BASIC PERMIT FEE WSBCC SURCHARGE SINKS DISHWASHER GARBAGE DISPOSAL 204.98 512.45 4.50 6.00 6.00 6.00 Total Calculated: 739.93 Deposits/Receipts: 0.00 Total Due: 739.93 CITY APPROVED FOR SUBMITTAL Building Planning Public Works 11 i Initials /Date • THIS IS NOT A RECEIPT ciimoua(U Cu lik-i-&_.) !Wk U` <IAJ/ 040 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: ZZ Z. S. ck') t!a- � ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: LU/tC.yyvh\ ,� tltloo ci ( PERMIT DESCRIPTION: &Icemen/ c ea. CO/ / f !� 4, Aco (,��rl� �A C€- to (QA ; igtRUILDING PERMIT D CHANGE IN USE •10 GRADING RELOCATION D SIGN DTENANT D MANUFACTURED HOME MOTHER- OWNER O HER OWNER / APPLICANT INFORMATION D OWNER: 'ecl u.'b/ .8 2fte PHONE: c32-(0- L/I -I S FAX: 34/516 A(VA� ADDRESS: 2 S rtx. ® C✓rty d�' . ekane (%tIley q CI ,STATE, ZIP CONTRACTOR: 5/0/t' PHONE: FAX: ADDRESS: CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # APPLICANT: PHONE: FAX: ADDRESS: CITY, STATE, ZIP ARCHITECT: PHONE: ADDRESS: FAX: CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: 30% SLOPES ON PROPERTY: BUILDING HEIGHT TO PEAK: /5 "11 OCCUPANCY GROUP: BUILDING DIMENSIONS: CONSTRUCTION TYPE: NUMBER OF STORIES: STRUCTURES ON PROPERTY: NUMBER of BEDROOMS: CRITICAL AREAS: FLANKING SETBACK: CURRENT PROPERTY SIZE: FRONT SETBACK: CURRENT PROPERTY USE: REAR SETBACK: CURRENT SEPTIC USE: /< r5CLiL LEFT SETBACK: CURRENT WELL USE: RIGHT SETBACK: IMPERVIOUS SURFACE AREA: MAIN FLOOR SQ FT: 2N0 FLOOR SQ FT: UNFIN BASEMENT: FINISHED BASEMENT: GARAGE: COVERED DECK: DECK: w„t cch tvN 6)0.41-ahy L7k/ A 5 erne/I K Kik fii)19. C -(2(Z14( /aW( la(e 116,' t METHOD 0 ❑ CASH fiTt OE Spokane ,,,Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT ADDRESS: Z Z Z- s c)o e4 Ru DESCRIPTION PERMIT USE: # OF UNITS OWNER: etchct✓�l eo v�,k COST PHONE (Daytime Contact): AMOUNT MAILING ADDRESS: S4mE- 4s ii-bvve G- ir ,iSpo „e t/4//ey in/A-_ q`1 U / 10 (street) (city/state) (ZIP) $6 CONTRACTOR`_ p ! r LICENSE #: URINALS MAILING ADDRESS: PHONE #: $6 - (street) (city/state) (ZIP) PLUMBING FIXTURES DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 - 5 SINKS LAVS/BASINS, BAR, FLOORaggiD LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 1 X $6 - 6 DISHWASHER / X $6 - 7 CLOTHES WASHER X $6 - 8 GARBAGE DISPOSAL / X $6 - 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 - 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X _ 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK V!SA ,Fast t_.__.- =. SUBTOTAL: PLUS PROCESSING FEE: $35.00 IN ■ TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: 0,010A, pilA'Pn E { f 2 MA\JERICK TUBE CORPORATION Energy Sales (800) 325-1777 Industrial Sales (800) 840-8823 www.maverick-tube.com 1 1 kit 1 II IMO �,� MI 1_ 4 MI; ..a .,54pAT vs ipur Khi i VA. 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