2003, 06-03 Permit App: BD03-252 ResidenceCity of
SPOKANE VALLEY
IECEfiWE
JUN 0 4 2003
(oW 003(p
�)
MI d D 1 Fx rs(- Dos
PERMIT# 6Bt3r2S�
BUILDING PERMIT APPLICATION
Box 1 OWNER nteg)G w�.t y /� Grosse£
/z.5's azc'p t /ZS&xmaf JOB LOCATION 1/02-
OWNER'S ADDRESS/,& �o �CITYop,' PHONE q9 .�5-2 beiC-'
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.,f/p, /0,41—
BOX 2 CONTRACTOR'S NAME
obtes al , //GF 13".04-1
CONTRACTOR'S ADDRESS /O2q/,v, L !/9',4tJll
CONTRACTOR'S REG.#E�jleu� •=7/
CONTRACTOR'S EXPIRATION DATE /la
(CARD MUST BE PRESENTED AND COPIED OR VEF$IFIED)
PHONE 009 .4/c4
CITY ✓/47-J.G
BOX 3 CONTACT PERSON OF PROJECTh.""" fL IZE, 6( PHONE
ADDRESS //4,. 4%1./,116i102242- CITY
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
y-f224r
ZIP
BOX 5 ESTIMATED PROJECT COST $ /17:000 EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DES RIPTION
fWAIJ
�C€- "w� rel
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR ./;Z.2.6. 2ND FLOOR
3RD FLOOR ---tom— OTHER /
BASEMENT UNFINISHED —7
CARPORT ^ —t TOTAL
BASEMENT FINISHED
DECKS --i— GARAGE. /
13 ZZG HEIGHT TO PEAK OF BUILDING /"f— F
64/0-- ae°
BOX8 (x) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
(Xi NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY /3
IMPERVIOUS SURFACE
S
BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURN -RS, ,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
FT.
. FT.
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 conta
Your sewer purveyor and the Health District (See BOX 4)
t
BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Pu lic
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 HE
\BOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION 1S MADE.
)WNER/AGENT
DATE //OA, (OVER)
Staane�°�°'
,Walley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT _ 2"10,14,4
ADDRESS: _ /IBJ ZI./ fsrE.
PERMIT
USE:
OWNER:2-A.,44h49 assn�d6z'7t
(" & �
PHONE (Daytime Contact):• ,_Z�
i:!?: ?57 Z�
MAILING ADDRESS - -
//eo W sTti o4 r`a?X,w1. ze44- 5f2.0 -C
(street) (city/state) (ZIP)
CONTRACTOR:
�ioxasuE cS.rvic� /
LICENSE 1:
6�6.��� 45). 29:090
MAILING ADDR�ss:
PHONE 1:
c-4i'Slo -1100
/OZC- cel, 20'O' '4 1.bmrehu/ 444 lZQC
(street) (city/state) (ZIP)
PLUMBING FIXTURES
DESCRIPTION
DETAILS
t OF UNITS
X
COST
TOILETS
WATER CLOSET, BIDETS
Z.
X
$6
EQUALS
AMOUNT
2
URINALS
X
$6
GIO
3
TUBS
2-
X
$6
4
5
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
2-
x
$6
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
y
X
$6
6
7
8
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
l
X
X
X
$6
$6
$6
/2 . al
/2 •
a-
24 T
9
WATER SOFTENER
X
$6
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
NI.4
3
X
$6
X
$6
12
FOUNTAINS, DRINKING
X
$6
/0
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS -
X
$6
14
15
SEWAGE EJECTOR
WATER USING DEVICE
GRINDER, SUMP PUMP
X
$6
16
CROSS CONNECTION DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
VACUUM BREAKER, CHECK VALVE, AND
R.P.B P.D. FOR: VATS, TANKS, BOILERS
2-
X
X
$6
$6
17
SPRINKLER SYSTEM
X
$25
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
a5dt
19
20
MEDICAL GAS per outlet
NTTROUS, OXYGEN
X
$6
MISC. PLUMBING FIXTURE
X
$6
HOD OF PAYMENT
VISA.
ASH D CHECK ❑
:CARD NUMBER:
EXPIRES:
:'JRIZF'.D SIGNATURE:
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
/GZ
SiTolcane`
.Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT 7ZC",Q/L . - - -
ADDRESS /Lenz t G't/c
-
PERMIT y
USE:
OWNER27/4mo isiaep.QE RLS/adic.r/-inSL as.
PHONE (Daytime Contact). em7a3,_ i_024,5 -
MAILING ADDRESS: //G g 4 rfra,ct/f i3O
4/bi4Nitiet a'» "19.00.5-
9.00S(street)
(street)
(city/state) (ZIP)
CONTRACTOR:
c5�JXIPJrle- �,aeg///LE /FiO
LICENSE 7:6-ns-lu'7 4cee) /0' . Z6-. 000
MAILING ADDRESS:
/� �� //'
/ci,. C4�V. �i✓/4'4 41
4t/.Ia4C.
PHONE o:
539 X3 e-� ?o &c,
e -'A 7`-9 i
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES.
DANKCARD NUMBEii
AUTHORI7F'Tl SIGN All IR F.
DESCRIPTION OF WORK
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
-OR<100,000
/
X
515
-
/4 °
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR < 400000
X
550
-
4
UNLISTED APPLIANCE(ADDTnONAL FEE)
>4W,000
X
5100
-
5
USED APPLIANCE(WSEC min. AFUE rating)
or<400,000
X
550
-
6
USED APPLIANCE(WSECmin.AFUE rating)
>403.00
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
-
. 10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
$95
-
12
CAS LOG, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
a
X
510 ,
-
70 OW
lg
MSG FUEL BURNING APPL
-
X
510
-
17
GAS PIPING (et Outlet)
-
3
X
51
3 n
19
VENNI L
X
510
Oa
19
VENTILATINGATING FANS
-
4/
X
510
•
Cf
i
20
AIR HANDLER (DOES NOT Include ducting)
• OR < 10.000CFM
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 B HOOD
-
X
510
-
25
HEAT PUMP/AIRCONDMONER
0-3 TON
X
512
-
26
AIRCONDMONER
3-15 TON
/
X
520
-
.0 In
27
AIRCONDITIONER
15-30 TON
X
525
-
28
AIRCONDEIIONER
30-50TON
X
535
-
29
AIRCONDrIIONER
+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
-
NEM
SUBTOTAL:
td
PLUS PROCESSING FEE:
<( $3!55..00
TOTAL PERMIT FEE DUE4/L/2
_Sliiii �rh ,{
DANKCARD NUMBEii
AUTHORI7F'Tl SIGN All IR F.