2003, 04-23 Permit App: BD-03-164 ResidenceCity of 1
SPOKANE VALLEY
PERMIT # BOD,= !LoLj-
BUILDING PERMIT APPLICATION
Box 1 OWNER JOB LOCATIONS . 134 (2 L Wet -3k -4 -)OWNER'S ADDRESS pp CITY PHONE �f
DESCRIBE JOB e -CS C.rc_t- CP
/C-.-1 a rc(
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME LL1`-P Se-Ff IV\ VC? (1/01‘.)457 PHONE 92.2.- L(z1
CONTRACTOR'S ADDRESS 1(-)SZO t. SCC?trg2(f-r CITY U Et fkLc.
CONTRACTOR'S REG.# 0 -LA SFS(`,) DC{ RF EXPIRATION DATE I Z�'� -2-c0L1
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT (I'L-. VP P Sr.({rn clt PHONE 619g-7733
ADDRESS ( IDS LID £ . 5r[(2 i l^fia_IftITY U LIZIPD ri m ZIP q q 0 0
BOX 4 SEWER AVAILABILITY P S WATER AVAILABILITY L/ £ S
BOX 5 ESTIMATED PROJECT COST $ - EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER Ct-1- B €L)< 1 roiarr S H6.LL F» C Ch(f. .H'fOQ PUD
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER
LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR - / ,--0- OTHER /
1ST FLOOR / /33S -2ND FLOOR / -�-
BASEMENT FINISHED / -0 —
/ -0- GARAGE /
HEIGHT TO PEAK OF BUILDING iJ FT.
BASEMENT UNFINISHED / /307 DECK
CARPORT / TOTAL / 321$ ?
BOX 8 Al SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL/.INDUSTRIAL
( ) TENANT IMPROVEMENT
()it) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE 191/ • SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins)
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size (if known) 1" Also see BOX 4
BOX 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department. -
I VERIFY UNDER THE PENALTY OF P
CORRECT TO THE BEST OF MY
ABOVE PREMISES TO PERFO
OWNER / AGENT
RJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
• EDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
K FOR WHICH THE APPLICATION IS MADE.
DATE yn-o3
(OVER)
IOD 0
LSH
Vokaile Spokane Valley, WA 99206
Walley
Plumbing Permit Application
JV!-VVV"'VVW' 11tVIte
509-688-0037 - Fax
i
PROJECT I' f1 , • `,p
ADDRESS: $34 5 ./ 6RLU)0cl /wNE
DESCRIPTION
PERMIT( !� Q �Q `I
USE: $iD Oc4�p� oil mS,W6
OWNER CLIFF 5`11 -I -m I -R,
X
PHONE (Daytime Contact): CCt"C'f 9 99 9'7 33
r /
MAILING ADDRESS:
i Co SZD E 5 EC2E7592i61"
veRROfitt IAJA
R96 3 7
(street)
(ZIP)
Z
,(�dty//state)
CONTRACTOR'f MINI q 5 PLa m.IN&
$6
LICENSE It:
I Z
MAILING ADDRESS: -
URINALS
PHONE S:
X
$6
(street) (city/state)
(ZIP)
3
PLUMBING FIXTURES
EXPIRES:
CARD NUMBER
ORIZED SIGNATURE:
DESCRIPTION
DETAILS
tOF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
Z
X
$6
-
I Z
2
URINALS
X
$6
-
3
TUBS
X
$6
-(O
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
$6
-
((7
5
SINKS
LAYS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
I I
^-/f
X
$6
`
�.IY
6
DISHWASHER
I
X
$6
-
'^
W
7
CLOTHES WASHER
I -
X
$6
-
( Q
8
GARBAGE DISPOSAL
)
X
$6
-
t•-( A
9
WATER SOFTENER
X
$6
-
K
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
I
X
$6-
,( Q
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
3
X
$6-
l
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
RP.BP.D. FOR: VATS, TANKS, BOILERS
X
86
-
'
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
] CHECK
1 lean T/ast
SUBTOTAL
PLUS PROCESSING FEE:
$35.00
■ - ■
,.—_ ._
TOTAL PERMIT FEE DUE:
/,; O
EXPIRES:
CARD NUMBER
ORIZED SIGNATURE:
Spdfange�1
"iBe
Mechanical Permit Application
Spokane Valley, WA 99206
JUrUUU-VVJU - 11lVl le
509-688-0037 - Fax
i
PROJECTQ
ADDRESS: A3q 6,(I&WA
-
Lgyic
PERMIT
USE:
SOF UNITS
OWNER
COST
PHONE (Daytime Contact):
MAILING ADDRESS:
1
FUEL BURNING APPLIANCE
(street)
(city/state)
(ZIP)
CONTRACTOR: SLUEpi. Am
1 `fTJ M 6
KiTI/
LICENSE I:
2
MAILING ADDRESS:
> 100,000
PHONE I:
X
519
-
(street)
(city/state)
(ZIP)
METHOD OF PA
❑ CASH ❑ CHECK 0
DATE:
0
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
SOF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,020
I
X
$15
•
��
/r • `CJ
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
$50
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 900,000
X
s100
•
5
USED APPLIANCE (WSEC moi. AFUE rating)
- or < 400,000
'X
S50
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 900,000
X
5100
-
7
BOILER/REFRIGERATION
1-103M BTU
x
S15
-
8
BOKER/REFRICERATION
101- 500M BTU
X
$28
•
9
BOILER/REFRIGERATION
501- 1,000M BTU
X
$39
-
10
BOILER/REFRIGERATION
1001-1,750M BTU
X .
S57
-
11
BOILER/REFRIGERATION
+1750M BTU
x
S95
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
I
X
$10
IO•CC' .
13
RANGE
-
X
S10
-
l9
DRYER
—
f
x
310
I Q .X.
15
FUEL BURNING WATER HEATER
-
I
X
510
•
1ID-co
16
MSC FUEL BURNING APPL
-
X
510
-
17
GAS PIPING (ea Outlet)
-
3
x
S1
-
?>.
18
DUCT SYSTEMS
-
X
S10
•
19
VENTILATING FANS
-
X
510
-
PY:/•
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
S12
-
21
AIR HANDLER (DOES NOT h,dude ducting)
> 10,0110 CFK
X
519
-
22
EVAPORATIVE COOLERS
-
X
$10
•
23
TYPE I HOOD
-
X
S50
•
24
TYPE D HOOD
-
I
X
S10
-
/O•co
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
-
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIRCONDITIONER
15.30 TON
X
$25
-
28
AIR CONDITIONER
30-50 TON
X
11.5
•
29
AIRCONDMONER
.50 TON
X
S60
-
30
LPG STORAGE TANK
-
X
$10
-
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
•
32
WOOD STOVE - FREE STANDING
-
X
525
•
MENT
nail17KC r•
SUBTOTAL
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE 25 e0 -
❑ CASH ❑ CHECK 0
DATE:
0
EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
ser /I0 k5
Foo /75
4L 4 s/ee /
/'00„644 //
Aoter To C-41
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APPROVED BY '71C(
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