2005, 10-10 Permit App: 05003631 ResidenceProject Number: 05003631 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 10/10/2005 ' Page 1 of 4
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -GAS Contact: NORTHWEST CONSTRUCTION
Address: 8611 W WHITE RD
C - S - Z: CHENEY, WA. 99004
Phone: (509) 838-1861
Group Name:
Site Information: Project Name:
Setbacks: Front 32 Left: 24 Right: 12 Rear: 73
Plat Key:
Name: RANGE
District: East
Parcel Number: 45171.0240 Block:
SiteAddress: 1304 N FELTS RD
Location:: CSV
Zoning: UNKN Unknown
Water District:
Area: 12,867 Sq Ft
Lot:
Owner: Name: KIMSEY, JOHN & CAROL
Address: 1210 N ARGONNE RD
SPOKANE VALLEY, WA 99212-261
Hold: ❑
Width: 86 Depth: 149 Right Of Way (ft): 40
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information ,
Review
Site Plan Review
Released 13y: -
Plan Review
Originally Released: 10/04/2005 By: CJJANSSE
Released By: - -
Approach/ Drainage
Originally Released: 10/10/2005 By: TMELBOU
Released By:
Sewer Review
Permits:
Originally Released: 10/04/2005 By: CJJANSSE
Released By:
Originally Released: 10/10/2005 By: CJJANSSE
Operator: CJJ Printed By: CJJ
Print Date: 10/10/2005
Project Number: 05003631 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/10/2005 Page 2 of 4
Approach
Contractor: NORTHWEST CONSTRUCTION & Firm: NORTHWEST CONSTRUCTION &
Address: 8611 W WHITE RD Phone: (509) 838-1861
CHENEY, WA 99004
Item Description
APPROACH INSPECTION
CONST IN ROW - APPROACH
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
Fee Amount
$25.00
$25.00
Permit Total Fees: $50.00
Building Pertnit
Contractor: NORTHWEST CONSTRUCTION & Firm: NORTHWEST CONSTRUCTION &
Address: 8611 W WHITE RD Phone: (509) 838-1861
CHENEY, WA 99004
Building Characteristics
Total Area 1280
Building Height 12
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
DECK R-3 VB 80 $1,200.00 80 $1,200.00
GARAGE U-1 VB 519 $9,861.00 519 $9,861.00
RESIDENCE R-3 VB 1,280 $95,590.40 1,280 $95,590.40
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Totals: 1,879 $106,651.40 1,879 $106,651.40
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Operator: CJJ Printed By: CJJ
Fee Amount
$1,032.95
$4.50
$413.18
Permit Total Fees: $1,450.63
Print Date: 10/10/2005
Project Number: 05003631 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without.a permit
Date: 10/10/2005 Page 3 of 4
Mechanical Permit
Contractor: NORTHWEST CONSTRUCTION & Firm: NORTHWEST CONSTRUCTION &
Address: 8611 W WHITE RD Phone: (509) 838-1861
CHENEY, WA 99004
Item Description
DUCT SYSTEMS
GAS APPLIANCE<=100,000BTU
GAS PIPING
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
GAS APPLIANCE - MISC.
Units Unit Desc
2 NUMBER OF
1 NUMBER OF
1 # OF UNITS
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Pluinbing Permit
Fee Amount
$20.00
$12.00
$1.00
$10.00
$10.00
$10.00
$10.00
$20.00
$93.00
Contractor: NORTHWEST CONSTRUCTION & Firm: NORTHWEST CONSTRUCTION &
Address: 8611 W WHITE RI) Phone: (509) 838-1861
CHENEY, WA 99004
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 2 NUMBER OF $12.00
SINKS 4 NUMBER OF $24.00
SHOWERS 1 NUMBER OF $6.00
TUBS 1 NUMBER OF $6.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Operator: CJJ Printed By: CJJ
Permit Total Fees: $84.00
Print Date: 10/10/2005
Project Number: 05003631
Inv: 1
Application
THIS IS NOT A.PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/10/2005
Page 4 of 4
Notes:
Payment Summary•
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$50.00
$1,450.63
$93.00
$84.00
Invoice Amount
$50.00
$1,450.63
$93.00
$84.00
$1,677.63 $1,677.63
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$1,450.63
$93.00
$84.00
$0.00
$1,677.63
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: CJJ Printed By: CJJ Print Date: 10/10/2005
Sfieliane
Valley
BUILDING PERMIT APPLICATION WORKSHEET
fc@t} Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
OCT U 3 2065 n Spokane Valley, WA 99206
one: (509) 683-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: / 3 6 9 f, Ft /.7z-,
Assessor's Tax Parcel Number(s): q5/7/,, da 3 g Lo/ Z
Legal Description: b * A Cf So7O `C%2-oS -&,n 3
qcs-/ 7/ , a3 $
PERMiTDESCRIPTION: /�N r.J 1(5 _ le 7-RVif
�c Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
�Or7�,or. n
OWNER/APPLICANT INFORMATION
❑ -Owner. 75-04 r`- 61 nt es-ey 1E1 Applicant: CO 01)Z.
Phone: 7Z2 -252s Fax: ]� Phone: Fax:
CAd-dress: j /p 4 4 gno Ne ` Address:
. G l/aYke e, a (/q. t t4/4 7 7,2 /2_
city 1 State p Code City State Zip Code
0 Contractor - A _ e f tSf✓ef•cvn❑ Architect:
Phone: Fax: 83 -v: c Rea k/ Phone: Fax:
dgress: � ii uJ c%_ Rc1 Address:
C{leaey. oyf - 9gcog
City State Zip Code City State Zip Code
•
WA State Contractor License #:. ke/-k e g 9i D Contact: f
Spokane Valley Bus. Liscense #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:/a?t
DIMENSIONS:
if-5#
OF STORIES: /
MAIN FLOOR 50. FTG:
tz
2" `' FLOOR SQ. FTG: a
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
5/9 c(-,
DECK/COV. PATIO SQ. FTG:
$0 Sq F1
enc --
OCCUPANCY GROUP:
CONSTRUCTION TYPE•
/A)0 0
HEAT SOUP:
A-
# OF BEDROOMS: 3
TOTAL HABITABLE SPACE:
IMPERVIOU URFACE AREA:
COST OF PROJECT:/ $
1% 00O�
30% SLOPES ON PROPERTY:
ii11
SEWER OR ON-SITE SEPTIC
SYSTEM? DU R(: c kJaleC
Se LA) af
MANUFACTURED HOME
22.x- %l_n x (dt-P) l)
Nidth: I Length: -
Manufacturer.
Year.
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
=ire Sprinkler. # of Heads: Fire Alarm: Paint Booth:
rent: Fireworks Display: Blasting: Date/Time: _ - -
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner.
kddress:
Phone: Fax:
City State Tip
nspector. Phone: Fax:
4ddress:
city
State Tip
SPECIAL INSPECTIONS
]
BOLTING ❑ CONCRETE
❑ REINFORCEMENT ❑ WELDING
=im1 Name: Phone:
nspector(s):
Fax:
)ISCLAIMER
he permitee verifies, acknowledges and agrees by their signature that: 11) If this permit is for construction of or on a
!welling, 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
ransaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Zeferenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
'ermit is nota permit or approval for any violation of federal, state or local laws, codes or ordinances.
)wnership of resulting development rights granted by any issued permit inure to t jroperty owner.
'rint Name /$�Je(�% a )71 --Signature
4ethod of Payment: (Faxed permit applications will only be accepted with major bankcard)
)(Cash ❑ Check ❑ Mastercard
lankcard #:
wthorized Signature:
❑ VISA
Expires:
VIN#:
❑ Other
Project Address:
Owner. 3614.v.
PLUMBING PERMIT APPLICATION
Phone:•(509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054-'
Permit Use:
1610.
Phone (Daytime Contact):
1369 /U. Fd -/s
Mailing Address: /4(10 • A)_
4- �4 9 0.•
City
Contractor. Ar
Mailing Address:
1
e my Pe/1. n4
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley; WA 99206,
State Zip Code
License #: Phone #: ic 3 124 L
city
Zip 74 ere/
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET. BIDETS
- 9..,
X
$6.00
=
2
URINALS
0
X
$6.00
=
3
TUBS
/
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
/
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN.
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.0D
=
6
DISHWASHER
/
X
$6.00
=
7
CLOTHES WASHER
/
X
$6 DD
=
8
GARBAGE DISPOSAL
X
$6 00
=
9
WATER SOFTENER
0/
X
$6.0D
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
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
7Qe
.2 h3['
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
• GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56 00
=
20
MISCELLANEOUS PLUMBING
FIXTURE ..
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00.
_
-
METHOD OF PAYMENT:
❑ CASH 0 CHECK
DATE
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address: 13 6 7 Al' / 2-5
Community Development Department
Building Division
11707 E..Sprapue Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Owner. `rb%�a, ti K) Sat t. Phone (Daytime Contact): `e 3 II - / `66
Mailing Address: /d A!'moo csn...�- -
,�1 Cty State Zi Code
Contractor. Nart k- je (I 6 ti Strut/ License #: P ofd #: '. ! 8 6
Mailing Address: Q• Re&�CDC1-C3 k)-$�0%/ 1,J ,•tiC. - (&i.v.� 9c
CiN State Zi Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
/
-X
112.00
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400.000
More than 400,000
X
X
$50.00
5100.00
=
=
4
UNLISTED APPLIANCE (Additional Fee)
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
'
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
535 00
=
11
BOILEP/REFRIGERATION
More than 1,750M BTU
X
560 DD
=
~
12
GAS LOG, GAS INSERT, GAS FIREPLACEX
510.00
=
13
RANGE
Py
X
510.00
=
14
DRYER
,
X
$10.00
=
15
FUEL BURNING WATER HEATER
I
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
110.00
=
17
GAS PIPING (each outlet)
^
X
11.00
=
18
DUCT SYSTEMS
1
X
510.00
=
19
VENTILATING FANS
X
510.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
115.00
=
22
EVAPORATIVE COOLERS
X
510 00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE II HOOD
1'
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
520.00
=
27
AIR CONDITIONER
15-30 TON
X
525.00
=
28
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510 00
=
32
WOOD STOVE - FREE STANDING
X
125.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS'
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR -RESIDENCE
X
519.00
=
37
INCINERATOR - COMMERCIAL
X
522.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD 14:
DATE:
SUBTOTAL
PROCESSING FEE
535.00
- EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: