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2004, 07-28 Permit App: BLD-04-07179 ResidenceTHIS IS NOT A PERMIT �,r001� Penalties will be assessed for Sakane commencing work without a permit ,;o0Va11ey NEW SINGLE FAMILY RESIDENTIAL 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Application #: BLD -04-07179 Job Address: 1205 S HIGHLAND DR Applied: 07/28/2004 SPOKANE WA 99212 Issued: Description: NEW RESIDENCE W/ATTACHED GARAGE - GAS Expires: 01/24/2005 OWNER CONTRACTOR Subdivision: Lot: Blk: Parcel No: 45193.0612 Zoning: Owner: ANDREY GERMANOVIK Applicant: ANDREY GERMANOVIK Phone: (509) 217-0587 Address: 3808 E PACIFIC SPOKANE, WA 99202 Contractor: Phone: Address: Lic No: General Information: Fees: TYPE OF RESIDENTIAL PERMIT sfr PLAN CHECK FEE 599.10 VALUATION 189844 TYPE II HOOD 10.00 BUILDING HEIGHT TO PEAK 40 BASIC PERMIT FEE 1,497.75 DIMENSIONS 67 X 34 WSBCC SURCHARGE 4.50 # OF STORIES 2 TOILETS 18.00 FRONT SETBACK 55 TUBS 12.00 REAR SETBACK 82 SHOWERS 6.00 LEFT SETBACK 10 SINKS 30.00 RIGHT SETBACK 33 DISHWASHER 6.00 OCCUPANCY GROUP r-3 CLOTHES WASHER 6.00 GARBAGE DISPOSAL 6.00 CONSTRUCTION TYPE 5-b FLOOR DRAINS 6.00 STRUCTURES ON PROPERTY 1 WATER USING DEVICE 12.00 CURRENT PROPERTY SIZE 110 X 160 FUEL BURNING APPL <- 100,000 15.00 CURRENT PROPERTY USE UR 3.5 GAS LOG, INSERT, FIREPLACE 10.00 SERVED BY SEPTIC SYSTEM no DRYER 10.00 WELLS LOCATED ON PROPERTY no FUEL BURNING WATER HEATER 10.00 TOILETS 3 GAS PIPING 3.00 TUBS 2 VENTILATING FANS 40.00 SHOWERS (PER TRAP) 1 SINKS 5 Total Calculated: 2,301.35 DISHWASHER 1 Deposits/Re eipts: 0.00 CLOTHES WASHER GARBAGE DISPOSAL 1 1 POKANE VALLE#a Due: 2,301.35 FLOOR DRAINS 1 D FOR SUBMITTAL �c���` �p.cC; WATER USING DEVICE 2 i 13 FUEL BURNING APPL <= 100,000 1 GAS LOG, INSERT, FIREPLACE 1 :public DRYER 1 FUEL BURNING WATER HEATER 1 / GAS PIPING (ea. OUTLET) 3 VENTILATING FANS 4 TYPE II HOOD 1 rkS THIS IS NOT A RECEIPT J PROJECT APPLICATION WORK SHEET SPOKANE COUNTY DIVISION OF BUILDING & CODE ENFORCEMENT 1026 )XTST BROADWAY AVENUE I fir! SPO 9-4E7 675 9260 SPOKANE CDUNTY ' - SPECIFIC SITE INFORMATION Street address: r ly Assessor's Tax Parcel Number(s): Le al Description: eve,--& It (/� Project Description: N — cti •-41 ! v, c. Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home Permit ❑ Relocation O Sign ❑ Tenant (New/Change) ❑ Other Department Use Only Water District/Pun-eyor. Sewer District/Pu eyor Road width Setbacks, /❑ /tN G k. G .ta /V C) V lI Fax: Rear. School District Fire District Zoning Mailing Address: 3808 '� , Right: OWNER/APPLICANT INFORMATION Owner. Bwldtng Informtl©n Phone: � � '7 _ � s �y � ❑ Applicant: Phone: /❑ /tN G k. G .ta /V C) V lI Fax: as: Mailing Addrc: Unfinished basement sq. ft. 0 Mailing Address: 3808 '� , �a �: �'� C - Total habitable space 2nd floor sq. ft. / City, State, Zip Finished basement sq. ft. Occupancy group City, State, Zip Garage sq. ft. / _ 01'eez n/ Q Deck sq. ft. 7 `l am ' ❑ ontractor Phone ❑ Architect/ Engineer Phone Fax F 6 Mailing address Mailing address City, State Zip City, State Zip \a'A State Contractor license # Contact name:D a D H PROiR('T INFORMATION Bwldtng Informtl©n Building height to peak # of stories Main floor sq.ft-/ Unfinished basement sq. ft. 0 Dimensions Total habitable space 2nd floor sq. ft. / Finished basement sq. ft. Occupancy group Construction type Garage sq. ft. / _ Deck sq. ft. SI to Cost of p oject Heat source (electric, gas, etc.) Manufactured Home - ` Sign - Width: Length: What is the square footage of the sign faceli How high is the sign? Year: Make: # of signs Area of existing signs _ Proposed use Value Staff Representative: Relocation Fire Safety Finn Name What is the current use of this property? Previous address Will the site be served by a septic system?, Yes 0 No Paint booth Fire Sprinkler Tent Fireworks display Fire alarm _ Proposed use Value Staff Representative: Special Inspections Required? Non -Residential Energy Code Compliance? Finn Name What is the current use of this property? Phone Will the site be served by a septic system?, Yes 0 No Plans Examiner Phone Inspectors: Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( --.---."4') 0 Yes El No Are critical or hazardous materials used or stored on site? 0 Yes .eK No Address Staff Representative: Inspector Phone 0 Ccincrete 0 Welding 0 Bolting 0 Reinforcement Address ADDITIONAL SITE INFORMATION Are there structures on the property? 0 Yes g No Ifyer, ident on site plan What is the current property size? �, / (square feet or acres) / /0 T r ,v f 5-O 14 - Is any part of the property within 250 feet of a shoreline? Ifyes, identify on site plan 0 Yes A No What is the current use of this property? Is your property in a designated wildlife habitat area? /Don't know 0 Yes 0 No Will the site be served by a septic system?, Yes 0 No Is any part of the property within a 100 yr flood plain? Ifyer, ident f on site plan 0 Maybe gi Don't know 0 Yes 0 No Are or will there be wells located on the property? Ifyes, ident fr on the site plan 0 Yes !, No Are there any wetlands, streams or ponds within 200 feet of the property? Ifyer, identiij on site plan 0 Yes 4 No Is there evidence of fill or excavation on the property? 0 Yes 0 No Are there slopes greater than 30% on the property? (30 ft rise in 100 ft) ( --.---."4') 0 Yes El No Are critical or hazardous materials used or stored on site? 0 Yes .eK No DEPARTMENT USE ONLY E es' d Sht;.. �""` �L >ae��yt,c�r.. C � jyam} Aiea2 M - ': ;;; , �. +7�r2!4�•t. K,%[(.W-±. iei` F 1$public sewer aaitabi to the e?• ; YQr/'d � i�tG7�'•' �y'r,�3'.1� •"'fib,^'�'i.:P� ate. t• k+, �.r '. �anxe�'A�1I fTYes N Y±es< ht �ater'vatlabltd tht;site 3.Is"tlic: inside"tlye PSSA =: Q Yei . GD' 13"0 ,.=.:`rte . Is the piniiefttlocated.within 1000 fleet of a Natuctl`R D:'kes . ©:.No tiii :Aiea : ` Date Received: Staff Representative: METHOD OF PAYMENT VISA 0 CASH 0 CHECK 0 0 0 FAXED PERMITS WILL ONLY BE ACEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: SUBTOTAL TOTAIJEE MINIMUM PERMITFEHISi S£ MAIM CHECKS PAYABLE "FQSP ANE COUNTY PERMIT CENTE& :. : '. Roa�ne Project Address: Owner: Mailing Address: Contractor: Mailing Address: MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 License #: Permit Use: Phone (Daytime Contact): State Phone #: CARD AUTHORIZED SIGNATURE: Zip uN - 7 # OF TOTAL UNITS X = COST AMOUNT DESCRIPTION OF WORK 1 FUEL BURNING APPLIANCE E ual to or les-'"-- 100,000 X $15.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 = UNLISTED APPLIANCE Additional Fee Equal to or less than 400,000 X $50.00 = 4 UNLISTED APPLIANCE Additional Fee More than 400,000 X $100.00 = r63 USED APPLIANCE (WSEC min. AFUE X $50.00 = 5 rating)Equal to or less than 400,000 USED APPLIANCE (WSEC min. AFUE X $100.00 = rating) More than 400,000 7 BOILER/REFRIGERATION 1 - 100M BTU X $15.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 = 12 GAS LOG GAS INSERT, GAS FIREPLACE r X $10.00 = I X $10.00 = 13 RANGE / X $10.00 = 14 DRYER 15 FUEL BURNING WATER HEATER X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 = 17 1 GAS PIPING each outlet X $1.00 = 18 DUCT SYSTEMS X $10.00 = 19 VENTILATING FANS X $10.00 = 20 AIR HANDLER DOES NOT include ducting Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER DOES NOT include ductin Greater than 10,000 CFM X $19.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD X $10.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 = 28 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X $60.00 = 30 LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 = 32 WOOD STOVE - FREE STANDING I X $25.00 = METHOD OF PAYMENT: SUBTOTAL ❑ CASH ❑ CHECK ❑ VISA ❑ MC DATE: PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: CARD AUTHORIZED SIGNATURE: Zip uN - 7 *lane ,o0Valley • PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Project Address: #i) 6i / Permit Use: Owner: i{ n .riZ- 6'- O �> c� Phone (Daytime Contact): Mailing Address: t� c7027 104 e Zip Code City State Contractor: License #: Phone #: Mailing Address: City State BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK # OF UNITS X` COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 = 2 URINALS / X $6.00 = 3 TUBS 2— x $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6•0O = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT i X $6.00 = 6 DISHWASHER 1 X $6.00 = 7 CLOTHES WASHER 1 X $6.00 = 8 GARBAGE DISPOSAL i X $6.00 = 9 WATER SOFTENER X $6.00 = 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 INSTALLATION, 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 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 $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 _ METHOD OF PAYMENT: ❑ CASH 0 CHECK DATE 0 VISA 0 MASTERCARD EXPIRES: _ SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code Inspections performed 10 days after p scheduled completion to schedule call (509)688-0195 or Fax (509)688-0037. Any re- inspection will incur an additional $25.00 charge. 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 ROW Construction Permit Permit # ROW 04-574 Issue Date 7/28/2004 Account # Completion Date Issued by Ddompier Construction Utility Location of Property Project Description 1205S HIGHLAND DR driveway Comments CONSTRUCT NEW DRIVEWAY Applicant ANDREY GERMAN Contractor Name CRN # Individual Name INDIVIDUAL Address Contractor Phone # Bond Origination Date Bond $ Account # $0.00 Permit Fee Inspection Fee Total Fees Collected $25.00 $25.00 $50.00/---',,' Permittee Signature Approv ,d E Date * 41 I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Credit Card # Name of Holder Expiration Date Signature In addition to the permit application fee of $16.00 (utility) or $25.00 (construction), inspection on each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (1/2 hour) minimum. Permittee signature constitutes an agreement to these terms and provisions. Work completed satisfactorily (signed) Date PERMIT MUST BE KEPT ON SITE v • a ADDRESS ROAD WIO?H_N G FRONT cOMMEN Cy ---_.-_. REVIEWE dY This site plan is being submi"*d for the purpose of obtaining a building permit and is a true and correct representation of the proposal. All known "!«'s, dimensions, cua curb lines, structures Property ment have been identified. Also indicated are ew sands, 'kurres of water, teep slopes or other critical areas. igned: ate: • 0 1 W4 4.0 f t"'Q 4- . N 5SO t