2003, 06-03 Permit App: BD03-251 ResidenceMECEOWE
Tla
JUN 0 4 2303
City of n n (oW 003(o
SPOKANE VALLEYk RAN K (FA)1 (Dgg<UO3
BUILDING PERMIT APPLICATION
Box 1 OWNBRfl anw0,t.sy/-n& -- -
2,Q,s,/te.. nvc zz.F,StacEc JOB LOCATION //eon 4t 4s.a.peg
OWNER'S ADDRESS//(p u/taTYY PHONE �yj_? 2z'fs-
DESCRIBE JOB t4~N,t%z — y- natrUk,.r Z _ gni *.cS (L
P
AIts1/1..S, .Clf�).0E&C f
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP. A/pr/ -Mt^
BOX 2 CONTRACTOR'S NAME°907.1 a_ 7�it,k46t nay/ PHONE Z7-6 -a0410
CONTRACTOR'S ADDRESS/DlC7-240/4a0/- CITY !,0/,rte/
CONTRACTOR'S REG.#
/amu% //. 29. 096 EXPIRATION DATE A/4-
(CARD
/4(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT fljzstvL Qtjt4 PHONE j -67;817-2Tit�g'
ADDRESS di,/(- zcjg/ j/.1 f CITY J/jpr�y�jj/� ZIP sir r9ZQ.c-
BOX 4 SEWER AVAILABILITY
WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ //, J.A0 EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER 4'92 , 290a
LEGAL DE,,SCRIPTION
/A--/ 0-��r204/ 7-25-4),_,e . eVy ‘47u/sv1.
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) :
I
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR / OTHER
1ST FLOOR /4224.2ND FLOOR
BASEMENT UNFINISHED / DECK
CARPORT / I OTAL .— / .2Z6. HEIGHT TO PEAK OF BUILDING /S' FT
BASEMENT FINISHED
/ GARAGE r
BOX 8 (X) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
•,G 416 Cv
CsiCf�O�
()C) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY /3 4.1"9" S
IMPERVIOUS SURFACE S,
. FT.
. 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) Also see BOX 4
BOX 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contac
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.
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
:ORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF
\BOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION 1S MADE.
cS rlre/ft- DATE o% Zj (OVER)
)WNER/AGENT
HE
Sarrc 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
pokane Spokane Valley, WA 99206
ees.Valley
Plumbing Permit Application
509-688-0037 - Fax
PROJECT -.rsag.
ADDRESS: �/a2Z F,4,i eat24C t.
PERMIT
USE: - • . • .
OWNER 7x, »4z £'mcc-�`AYI�A�A%e- fecc
/� /4C,•
PHONE (Daytime Contact): 'Z_ Z��
MAILING ADDRESS:
//co (22 .raj,s,r/41 4Ardsn. helm 5'920f—
(street) (city/state) (ZIT)
CONTRACTOR:
�oxE c`�E.td/cam /<pu
LICENSE #:
6�6.e0/'dee) 4,• 2.2
MAILING ADDR6
/02 - �/. j,r/Oi•9w4 lt4rSxif
PHONE #:
*44 91,a
(street) (city/state) (ZIP)
PLUMBING FIXTURES
DESCRIPTION
DETAILS
A OF UNITS
X
COST
TOILETS
WATER CLOSET, BIDETS
Z
X
56
EQUALS
AMO LIN}'
2
URJNAIS
X
56
3
TUBS
x
56
4
SHOWERS (PER TRAP)
BATH, STALL ON-SITE BUILT
2-
x
56
5
SINKS
LAYS/BASINS, BAR FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
y
X
56
6
DISHWASHER
X
56
/2 . "
/2 -
2i1
7
CLOTHES WASHER
X
56
8
GARBAGE DISPOSAL
X
56
G
to •
9
WATER SOFTENER
X
56
10
ELECT. HOT WATER TANK
NOTE: II GAS, SEE MECHANICAL
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
Hl -
3
X
56
X
56
12
FOUNTAINS, DRINKING
X
56
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56
14
15
SEWAGE EJECTOR
WATER USING DEVICE
GRINDER, SUMP PUMP
X
$6
ICE AND/OR COFFEE MAKER HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
Z
X
56
16
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK VALVE, AND
R.P.BP.D. FOR: VATS, TANKS, BOILERS
X
56
/ 2'
17
SPRINKLER SYSTEM
X
525
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
56
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
20
MISC. PLUMBING FIXTURE
X
56
'HOD OF PAYMENT
Meta
YIS4
ASH , ❑ CHECK ❑ Ea/
❑ _'`"'
EXPIRES:
BARD NUMBER:
:ORIZED SIGNATURE:
SUBTOTAL:
PLUS PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: // y`
*Mime
Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037- Fax
PROJECT .276,42a
ADDRESS de 72.
. - - - -
gar 67°,,e4
PERMIT
USE:
OWNER2 Ng JS-iNfiAAE 32esottiedriKL as.
PHONE (Daytime Contact): a9,_ Fe3 7_224'5
MAILING ADDRESS: //G a- rtA4Amg/,4
1/.fi/,talgid 1 a"r¢ 99ao,5
(street)
(city/state)
(ZIP)
CONTRACTOR:
�J neziGF 72'OiN
LICENSE d,E,toridar /PC14!J /0. Z.P, 0,0
MAILING ADDRESS:
/02Sra! rd/ 44,ri9 9tX4*e/4 ,
PHONE A: ��,ryy�
s4'7C0—,?0 (?)
.'f//I
n2.0<-
(street)
(city/state)
(ZIP)
METHOD OF PA
9 CASH 9 C
DATE: EXPIRES:
BANKCARD NUMBER_
AUTHfRT7T-T) SIGNATI IR P.
DESCRIPTION OF WORK
A OF WAITS
X
COST
EQUALS
AMOUNT
I
FUEL BURNING APPLIANCE
-OR<103,000
[
X
515
-
/or ro
2
FUEL BURNING APPLIANCE
> 100,000
X
519
•
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
• or <400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,030
X
5100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
-
8
BOILER/REFRIGERATION
101-500M BTU
X
528
-
9
BOILER/REFRIGERATION
501-1,000M BTU
X
539
•
I0
BOILER/REFRIGERATION
1001- 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
CAS LOC, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANCE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
2
x
510
-
20 A
16
MISC. FUEL BURMNO APPL
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
3
X
51
3 -
1B
DUCT SYSTEMS
X
510 -
19
VENTILATING FANS
-
4/
X
510
-
67j g dW
20
AIR HANDLER (DOES NOT Include ducting)
- OR< 10A00CPM
X
512
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
23
TYPE I HOOD
_
X
550
-
24
TYPE II HOOD
-
-
X
510
-
25
HEAT PUMP/AIRCONDrnONER
0.3 TON
X
512
•
26
AIRCONDMONER -
3-15 TON
/
X
520
-
Z dl.
27
AIRCONDFRONER
-' 15-30 TON
X
525
-
28
AIRCONDITIONER
30-SOTON
X
535
-
29
ABR CONDITIONER
.50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
-
KENT
— _
SUBTOTAL:
0
PLUS PROCESSING FEE:
535.00
TOTAL PERMIT FEE DUE./�
DATE: EXPIRES:
BANKCARD NUMBER_
AUTHfRT7T-T) SIGNATI IR P.