2004, 02-11 Permit App: BLD-04-03539 DuplexSpokane
Valley.
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
$�9 9z/ i?/ r,/
ASSESSOR'S TAX PARCEL NUMBER(S):
/ C / /J
LEGAL DISCRIPTION: ra G l� /'S of5J or� `Y/& f 5r --/319-0S
PERMIT DESCRIPTION:
RIBUILDLNG.PERNIIT CICHANGE IN USE 0 GRADING
to RELOCATION
Q SIGN ®TENANT
®MANUFACTURED HOME
0 OTHER
OWNER / APPLICANT INFORMATION
® OWNER: /2"/ ✓C_ t;%frsij )/1
PHONE: 99.9- o FAX: �' \
ADDRESS:ca A/05-
ofi
® APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
TY41"0
AT,ZIP
®CONTRACTOR: f/ Se -Ur / ai
PHONE: c� j� Yrs FAX:
ADDRESS: ,
CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE #
ARCHITECT:
PHONE: FAX:
ADDRESS -
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 7.//2„)
�/ (2 00
BUILDING HEIGHT TO PEAK:-/oC
BUILDING DIMENSIONS: -24459
NUMBER OF STORIES:
NUMBER of BEDROOMS: 6
FLANKING SETBACK: 5
FRONT SETBACK: 3
REAR SETBACK:
LEFT SETBACK:
RIGHT SETBACK:
3O
30% SLOPES ON PROPERTY:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY:
CRITICAL AREAS:
CURRENT PROPERTY SIZE:
CURRENT PROPERTY USE: /./aOt Lt,
CURRENT SEPTIC USE: Na
CURRENT WELL USE:
/4/ �
IMPERVIOUS SURFACE AREA: % AW
MAIN FLOOR SQ FT:7 598
2N0 FLOOR SQ FT:
UNFIN BASEMENT:
FINISHED BASEMENT -
GARAGE: j ��
GARAGE: 9e }l% Q
/ / it
COVERED DECK: CJ
1
DECK:
*lane.0001;s°
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
PROJECTQ
ADDRESS: f $2 / , fiTo/
PERMIT
USE:
OWNER:
/S�veCpr
# OF UNITS
PHONE (Daytime Contact).
g/
/A
MAILING ADDRESS:
fOcAom7s
,vie M idg 77,v / -/us—
(street)
(city/state) (ZIP)
CONTRACTOR:
17
LICENSE #:
MAILING ADDRESS:
//
-
PHONE #:
2
(street)
(city/state) (ZIP) -
PLUMBING FIXTURES
METHOD OF
0 CASH
DATE. EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE-
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
86
-
2
URINALS
X
86
-
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
' '
X
$6
-
6
DISHWASHER
2
X
86
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF CAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
86
-
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
86
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE MB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
1
I-y
1
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D FOR: VATS, TANKS, BOILERS
X
86
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X'
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
86
-
20
MISC PLUMBING FIXTURE
X
$6
-
PAYMENT
VIS. .r,• -
] CHECK ❑ :, eyr.:>:. ❑
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE. EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE-
*Wane
Mechanical 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:
DESCRIPTION OF WORK
PERMIT
USE:
OWNER
X
PHONE (Daytime Contact).
MAILING ADDRESS:
AMOUNT
(street)
(city/state) (ZIP)
CONTRACTOR:
)
LICENSE if:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH D C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
• OR < 100,000
)
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
•OR<400,000
X
550
4
UNLISTED APPLIANCE (ADDrIIONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
• or < 400,000
X
550
•
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
•
7
BOILER/REFRIGERATION
1 - 100M BTU
X
§15
•
8
BOILER/REFRIGERATION
101- 500M BTU
X
528
•
9
BOILER/REFRIGERATION
501- 1,000M BTU
X
539
•
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
11
BOILER/REFRIGERATION
+1750M BTU
jX
595
•
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
13
RANGE
X
510
•
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
--
ted-
X
510
16
M1SC FUEL BURNING APPL.
-
X
510
•
17
GAS PIPING (ea. Outlet)
_
1.1
X
51
-
18
DUCT SYSTEMS
-
X
110
•
19
VENTILATING FANS
-
(,f
-f
X
510
•
20
AIR HANDLER (DOES NOT include ducting)
• OR<10,000CFM
X
512
•
21
AIR HANDLER (DOES NOT uiclude ducting)
> 10,000 CFM
X
519
•
22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
550
•
24
TYPE R HOOD
--
''
X
510
•
25
HEAT PUMP/AIRCONDITIONER
0-3 TON
X
512
•
26
AIR CONDITIONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
525
•
28
AIRCONDI1ONER
30-50 TON
X
535
•
29
AIRCONDIUONER
,50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
•
31
WOOD OR PELLET STOVE/INSERT
-
X
510
•
32
WOOD STOVE - FREE STANDING
-
X
S25
•
_
YLENF
=iliaI `.-;-.:
'-. VISA'-. r <
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE: —
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
71.
100'
in
( Property line
ci
0
1
co
O
UNPLATTED
10' acquisition per
CRP 1409
100'
N
200.38 S00'05'04"W
i5Freperty Ilse
111.01
89',30'48"W
lnoress/Egress Sewe:
Utllit. Easement
111.01IOC
M' TRACT "8"
sat 011.117 SOFT.
32'
— 70'
388 SO F1 N8 '3503' O
26.95 N
co
0
O
84 05 "
N89'35'03"E
5'_)
Property line
TRACT "A"
10,021 SQ FT.
LI
t
O
1f)
O
co O
a5 0
o Z
N 89'35' 03"E
111.00
0
H
Property line
N0e0504 E
z 23.78
,rte Building Setback line
Utility Easement
CL BROADWAY AVENUE
PLANNING DEPT. APPROVED
BY4L l
DATE.
0 25 50 100
100'
o
N
CL FELTS ROAD
20'
Found PI( nod—/
20'
PROPERTY DESCRIPTION
Tract "B" of Short Plat SP -1319-03
AL SEVERSON
P.D. BOX 141735
SPOKANE, WA. 99214
999-6080
11 _ I.I II I: I.Iay a. i_I.!,-i. lig.... i_I.1 - .•