2009, 04-08 Permit App: 09000747 Duplex•
Project Number: 09000747 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date. 4/8/2009 Page 1 of 3
Permit Use: NEW DUPLEX -SEWER 814/816 N FELTS Contact: SEVERSON, AL
Address: PO BOX 141735
C - S - Z: SPOKANE VALLEY, WA 99214-1735
Setbacks: Front Left: Right: Rear: Phone: (509) 999-6080
Group Name:
Site Information:Project Name: 814 & 816 N FELTS
Plat Key: Name: Range
District: Nort
Parcel Number: 45171.1535
SiteAddress: 814 N FELTS RD
Location:: CSV
Block: Lot:
Zoning: R-3 SF Res District
Water District: 011 MODERN
Area: 10,242 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Owner: Name: SEVERSON, AL
Address: PO BOX 141735
SPOKANE VALLEY, WA 99214-17
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information:
Review
Building Plan Review
Released By:
Originally Released:
Driveway/Approach
4/7/2009 By: tmelbourn
Released By: -
NOT REQUIRED
Originally Released:
Landuse/Zoning/HE Conditions
4/8/2009 By: TMELBOU
Released
Sewer Review
Originally Released: 3/26/2009 By. mpalaniuk
Released By: .
Permits:
Operator: jmm Printed By: jmm Print Date: 4/8/2009
Project Number: 09000747
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/8/2009 Page 2 of 3
Contractor: OWNER
DescriptionGrp Type Notes
l&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
DECK OPEN R-3 VB
GARAGE U -I VB
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT .
Contractor: OWNER
Item Description
GAS WATER HEATER
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS 1 DUCT
RANGE
GAS LOG OR GAS INSERT
FLOOD -TYPE II
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
WATER HEATER - ELECTRIC
Building Permit
Firm: OWNER
Phone: (000) 000-0000
This Application:
Sq Ft Valuation
1,266 $122,586.78
1,559 $116,426.12
45 $675.00
756 $14,364.00
Totals: 3,626 $254,051.90
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Total Project:
Sq Ft Valuation
1,266 $122,586.78
1,559 $116,426.12
45 $675.00
756 $14,364.00
3,626 $254,051.90
Fee Amount
$1,861.75
$4.50
$744.70
$2,610.95
Firm: OWNER
Phone
Units Unit Desc
2 NUMBER OF
6 # OF UNITS
2 NUMBER OF
7 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Units
5
7
3
2
2
2
2
Operator: jmm Printed By: jmm
Plumbing Permit
(000) 000-0000
Fee Amount
$22.00
$6.00
$26.00
$77.00
$10.00
$11.00
$22.00
$174.00
Firm: OWNER
Phone: (000)
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
000-0000
Fee Amount
$30.00
$42.00
$18.00
$12.00
$12.00
$12.00
$12.00
$138.00
4/8/2009
Project Number: 09000747
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/8/2009
Page 3 of 3
Notes -
Payment Summary:
Permit Type
Building Pertmt
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount
$2,610.95
$174.00
$138.00
$2,610.95
$174.00
$138.00
Amount Paid
$729.02
$0.00
$0.00
Amount Owine
$1,881.93
$174.00
$138.00
$2,922.95
$2,922.95 $729.02
$2,193.93
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed 13y: jmm Print Date: 4/8/2009
Spokane
Valley.
Community Development
Residential Construction
Permit Application
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206 r�.EIVED 5
(509)688-0036 FAX: (509)688-6037 SPOKANE VALLEY
www.spokanevalley.org CITY OF
R 2a 2009
ew �tons Construction
Wadi tionLRemo4el
PERMIT NUMBER:9— %t-/ I
PERMIT FEE:
ther:
Accessory Bldg
Deck
SITE ADDRESS: b J y f 6,4 /Y reit5 Yed
LEGAL DESCRIPTION: r! 0 oP 5f 1222 —97
ASSESSORS PARCEL NO:
Building Owner: ,9/ S2.1% erso b
Contractor:
Name:Name:
/f/ Se ., ex -is n
TOTALHABITABLE SPACE:
Address:
SIM—
Address: aiy Fel-is igJ
City: State: Zip:
City: c-neuti/ State: L0)p Zrp:p/ad
/ Fax:
Phone: 79:7
Phone: Fax:
///n/2
Contractor Lic No: Exp Date:
,Contact Persona
30% SLOPES ON f/
PROPERTY: k/D
City Business Lic. No:
-
HEAT -RCE:
6tS
SEWER OR SEPTIC?
Sew e r -
- Name:
�y
Phone: a_pe
Cost of Project: $ l 5-0 COCA
Describe the scope of work in detail:
Proposed Use: €5 td eltr cLl
**************The followine MUST be complete: (write N/A if not applicable)**********************
HEIGHT TOPEAK: �
DIME4SrIQ :
# OF STORIES: 9,
TOTALHABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:AREA:
/2Rt /2G�
2'" FLOOR SQs-qaep. FTG: /
//��'I'/saI
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
s �`
FINISHED BASEMENT
SQ. FTG:/�
GARAGE SQ TG:
%
Cl.f�
DEC OV.,I�ATI. O�S)FTG:
�SOCj
30% SLOPES ON f/
PROPERTY: k/D
# OF BEDROOM :
6
CONS RUCTION TYPE:
tfIncil ft -An e.
HEAT -RCE:
6tS
SEWER OR SEPTIC?
Sew e r -
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be pr cessed.
SIGNATURE:
Method of Payment:
❑ Cash
Bankcard #:
Authorized Signature:
REVISED 2/15/07
❑ Check
❑ Mastercard
Expires:
DATE: Ards 2 —091
VISA
IN#:
ascosValley
PERMIT CENTER
11703 E. Sprague Ave., Suite B-3
Spokane Valley, WA 99206
509-688-0036; Fax 509-688-0037
www.snokanevalley.org
Affidavit in Lieu of General Contractor Registration
State of Washington )
County of Spokane )
1, SPJL.'C ct50/ 1
(Print name as signed)
, state as follows:
1. I have made application for a building permit from the City of Spokane Valley, Washington.
2. I understand that state law requires that all building construction contractors be registered with the
State of Washington. The exceptions to this requirement are stated under RCW 18.27.090, a copy of
which is printed on the reverse side of this affidavit.
3. I understand that prior to issuance of a building permit for work that is to be done by any contractor,
the City of Spokane Valley must verify either that the contractor is registered by the State of
Washington, or that one of the exemptions stated under RCW 18.27.090 applies.
4. In order to provide verification to the City of Spokane Valley of my compliance with this requirement, I
hereby attest that after reading the exemptions from the registration requirement of RCW 18.27.090, I
consider the work authorized under this building permit to be exempt under No. and will
therefore, not be performed by a registered contractor.
I understand that I may be waiving certain rights that I might otherwise have under state law in any
decision to engage an unregistered contractor to perform construction work.
gged and swo to efore me this
GG Day of 20 o?
J l\cu n
Notary's Name (Print)
ature
NOTARY PUBLIC in and for the State ,of
Washington, residing atr JUO_ County
CAMy Commission expires:
October 15, 2007
Page 1 of 2 P:\Community Development\Forms\Building Forms
Permit Center
SOS67.E a 11703 E Sprague Ave, Suite 13-3
Mane Spokane Valley, WA 99206
V-Qilcs (509)688-0036 FAX: (509)688-0037
Community Development w`v`vspokanevallev.org
Mechanical Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial j Residential
SITE ADDRESS:
Building Owner - 4/ 5420,4u-591
�
Name
Phone:
999 6fl�j
Fax:
/
Address. 520 I4 el ie
D t `I' l� ~
City: y f 1, (�+ f
`^ `^'^L (ice I
te: .. (1"1
IIS/
Zip: cjq�
Contractor
y^�
Name.
Phone:
Fax
Address:
City.
State:
Zip:
License No.
City Business Lic:
Contact
��1�
Name
Phone'
DESCRIPTION OF WORK
# OF UNITS X
COST
= TOTAL AMOUNT
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
2
.FUEL BURNING APPLIANCE
More than 100,000
X
$15 00
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
$50 00
6
-USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12 00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20 00
9
BOILER/REFRIGERATION 4
501 - 1,000M BTU - •
X
$25 00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35 00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60 00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10 00
13
RANGE
X
$10.00
14
DRYER
X
$10.00
15
FUEL BURNING WATER HEATER
X
$10 00
16
MISC FUEL BURNING APPLIANCE
X
$10 00
17
GAS PIPING (each outlet)
18
DUCT SYSTEMS
6
X
$1.00
X
$10.00
19
VENTILATING FANS
20
AIR HANDLER (DOES NOT include ductinq)
Equal to or less than 10,000 CFM
7
X
$10 00
X
$12 00
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$15.00
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE I HOOD
x
850 00
24
TYPE II HOOD
2-
X
$10 00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12 00
26
AIR CONDITIONER
4-15 TON
X
$20 00
27
AIR CONDITIONER
15-30 TON
X
$25 00
28
AIR CONDITIONER
30-50 TON
X
$35 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
$25 00
33
REPAIR 8, ADDITIONS
x
815.00
34
VENTILATION SYSTEMS
X
812.00
35
VENTILATION MECHANICAL EXHAUST
X
812.00
36
INCINERATOR — RESIDENCE
X
$19.00
37
INCINERATOR — COMMERCIAL
X
822.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK 0 VISA 0
CARD #
AUTHORIZED SIGNATURE
REVISED SJ2W05
EXPIRES
VIN'
SUBTOTAL
PROCESSING FEE
835.00
TOTAL PERMIT FEE DUE:
Permit Center
SOO-lime 11703 E Sprague Ave, Suite B-3
�MMlley
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.orv_
Plumbing Permit Application ❑ Commercial
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
SITE ADDRESS:
Building Owner f4t' L+ 9t^ �.,�0,�
�^'
Name:
(/�! FJ
Phone:
Fax:
Address:
to 0 fe,I
CI ty A
e
[are:
le y�
w ►`E
Zi
p q�I
Contractor
G 4—V" -Ark:'
/
Name:
Name:
Phone/Fax:
Address-
City:
State:
Zip
License No.
City Business Lic:
Contact
:cci,yNA__,
rl
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS X COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
2
URINALS
3
TUBS -
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
v
9
X
$6.00
X
$6.00
$6 00
X
$6.00
5
SINKS
LAVS/BASINS, BAR. FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
6
DISHWASHER
7
X
$6 00
X
$6.00
7
CLOTHES WASHER
2
X
$6 00
8
GARBAGE DISPOSAL
X
$6 00
9
WATER SOFTENER
X
$6 00
10
ELECTRIC WATER HEATER
NOTE IF GAS, SEE MECHANICAL
1
X
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6 00
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6 00
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
$6.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R P.B.P.D. FOR. VATS, TANKS,
BOILERS
X
$6 00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6 00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6 00
21
PRIVATE SEWAGE DISPOSAL/SYS
X
$20 00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
DCASH 0 CHECK VISA 0 MC
Card# /
AUTHORIZED SIGNATURE: l
REVISED 8/26/05
EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
VIN. TOTAL PERMIT FEE DUE:
iokane
HH valley.
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. spokaneval l ey. o ro
Approach Permit Application
PERMIT NUMBER:
PERMIT FEE:
PROJECT ADDRESS 6111 2/d N
START DATE
K/ n\-09)
ANTICIPATED COMPLETION DATE
Building Owner: C- - • -
�
Name: 41 s
D 5 f
Address:
Phon
Phone: crin 0
Contact Person ,_ 2
Name:
Phone:
h
State: FA) $(,
Fax: �/
PROJECT DESCRIPTION (Provide site sk
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions
Commercial/Industrial Driveway
al Road Section
Sidewalk Repair/Construction
Bond/Insurance certification must be on file with the city.
DISCLAIMER
The permittee venfies, acknowledges and agrees by their signatures 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before this
applicanon can be processed. /•.
Signature
Method of Payment:
9 Cash 0 Check
Bankcard #:
Authorized Signature:
REVISED 39[06
Dare {'Lkreil2520/
9 Mastercard rf VISA
Expires: VIN#:
Spokane
Valley®
Y
-For City Use -Only
PLUS Project Number <71- 07Lt.7,.
Project Address ?/ t/ / 8/(i //kits
:11703 E Sprague Ave Suite'B,3V Spbkane.Valley.WA 99206,''
509:688.0036 • Fax: 509.688.0037 1 permitcenter@spokaneyalley.org
As part of our on-going commitment to customer' service during the, review'-p'rocess, ofyouur,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 thedate for approval or permit issuance.
Tips for a Smoother Project Application Review
Submii complete, accurate plans and documents.
Extra time may be required for re-subtinttals as project application reviewers,
may beseveral days before they can look at your new or revised information.
i Designate a specific contact person to communicate with the City. .
While the person designated as the applicant's contact person with the City can bechanged:one individual with the
expertise for dealing with reviewer cotmnents would be the best choice for the entire review process.
Call staff regarding the status ofyour project only after the target date shown at the top of.the page -
Although yob should be coitacted'on or by the target date, please feel free to contact us•if you haven't.heardfirom us
by yo:o tat -get St
et date. kali' nrav contact i out 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 mark/pore exp. edrtiously. , •• .
work on innitiple applications and it•
- 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 nett 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 orice:it is started.. When'
this step is complete, your application will,be-routed to the appropriate staff and.remain in. their review queue:uritil it
comes up for review.
3. Technical Compliance. Once an application is administratively coniplete;.it is routed fo technical staff for compliance '
review., Depending on the type of project, technical staff may include multipleireviewers. 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 requhred):will be provided by
the Permit Specialist at that time.
WHITE - APPLICANT PINK -BUILDING FILE
REV 9/07
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PLANNING DEPT. APPROVED
BY. -7/14)--
DATE: Waici%zcb9
0 10 20 40
LOT "D" OF SP -1222-99
C5 impson Engineers, Inc.
CIVIL ENGINEERS Sc LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
PHONE (509) 926-1322 FAX (509) 926-1323
Founded 1946
P:\projects\13501-14000\13925\dwg\HorwoodProp.dwg 3/13/2009 11:42:38 AM PDT