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2004, 04-30 Permit: BLD-04-04230 DuplexCITY 11E r` Isp►411e .0,00Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 • NEW SINGLE FAMILY RESIDENTIAL PERMIT Job Address: 715 S FLORA LN VERADALE WA Description: NEW DUPLEX W/ATTACHED GARAGE - GAS Subdivision: Owner: Applicant: Address: Contractor: Address: GOOD SAMARITAN J S KIRKLAND CO 4005 S BEST CT VERADALE, WA 99037 J S KIRKLAND CO 4005 S BEST CT VERADALE WA 99037 Lot: Blk: Parcel No: Phone: (509) 928-6414 Phone: Lic No: (509) 928-6414 JSKIRC*029J7 Permit #: Applied: Issued: Expires: BLD -04-04230 Zoning: 04/30/2004 05/03/2004 10/30/2004 General Information: TYPE OF RESIDENTIAL PERMIT VALUATION CLOTHES WASHER GARBAGE DISPOSAL WATER PIPING/DRAIN-IN WASTE CROSS CONNECTION DEVICE SPRINKLER SYSTEM FUEL BURNING APPL <= 100,000 GAS LOG, INSERT, FIREPLACE RANGE DRYER FUEL BURNING WATER HEATER GAS PIPING (ea. OUTLET) VENTILATING FANS TYPE II HOOD HEAT PUMP/AIR COND 0 - 3 TON BUILDING HEIGHT TO PEAK DIMENSIONS COST OF PROJECT # OF STORIES # OF BEDROOMS 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 TOILETS TUBS SHOWERS (PER TRAP) SINKS DISHWASHER dup 216636 2 2 2 6 2 2 2 2 2 2 6 6 2 2 17 77 X 77 200000.00 1 4 20 15 5 5 r-3 5-n 1 100 X 129 no no 4 2 2 6 2 Fees: PLAN CHECK FEE BASIC PERMIT FEE GAS LOG, INSERT, FIREPLACE RANGE DRYER FUEL BURNING WATER HEATER GAS PIPING VENTILATING FANS HEAT PUMP/AIR COND 0 - 3 TON WSBCC SURCHARGE TOILETS TUBS SHOWERS SINKS DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL WATER PIPING/DRAIN-IN WASTE CROSS CONNECTION DEVICE SPRINKLER SYSTEM FUEL BURNING APPL <= 100,000 Total Calculated: Deposits/Receipts: Total Due: 659.58 1,648.95 20.00 20.00 20.00 20.00 6.00 60.00 24.00 4.50 24.00 12.00 12.00 36.00 12.00 12.00 12.00 12.00 36.00 50.00 30.00 2,731.03 2,731.03 0.00 THIS IS NOT A RECEIPT Spokane .000Valley NEW SINGLE FAMILY RESIDENTIAL PERMIT 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Permit #: BLD -04-04230 Disclaimer: 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. Ownership of resulting development rights granted by any issued permit inure to the property own q Date Print Name Staff Initials re THIS IS NOT A RECEIPT