2003, 06-04 Permit App: 03-282 DuplexI I io Of
TOKANE VALLEY
ox- I OWNER CSD SAf4
OWNER'S ADDRESS
1712.1 E, S-(14 A -NJ€,
DESCRIBE JOB I STo "
THIS PROPERTY IS OWNED
- --PARTNERSHIP C
DX 2 CONTRACTOR'S NAME
(ow " Qd-3 (P
PERMIT # i)-3 " 2
)]NG PERMIT APPLICATION
��JOB LOCATION ?Z4 S,
_CITY PHONE
4O -Pep h4*'Ce wAT 41e 01l v
W1 hvw6fe�
SINGLE/MARRIED
P114 F IT 60y-fiJ 17-A- 60
---------- ----_
< - ' 6A PHONE i�= 43Slp
CONTRACTOR'S ADDRESS 4Z5 S. �, T �-CITY VC (�L_64 , _ I VJA—, Gj�j0_31
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VE IFIED)
)X 3 CONTACT PERSON OF PROJ
ADDRESS {-BOV* F_-
:TbWt5 V4 "_1-W_b PHONE 8�q -`
CITY A -96j& ZIP
____________ ------ ___________________________-
)X4 SEWER AVAILABILITY `ii✓S�- e -Irl SQay,, VA-LWATER AVAILABILITY
----------------
)X5ESTIMATED PROJECT COST $ UPI&)Q EXISTING BLDG. VALUATION $
)X6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION BLV -K- 2i St_L_7100 24 1 T, 25 0,1 R 41.4e.11 l`W' M
(IF NECESSARY, PLEASE SU
CENSUS NUMBER
IX 7 BUILDING SQUARE FOOTAGE
3RD FLOOR —_r—'
BASEMENT UNFINISHED
CARPORT
X 8 ( ) SINGLE FAMILY —
(k) MULTIFAMILY (NO. OF UN
( )" COMMERCIAL / INDUSTRI
(
TENANT IMPROVEMENT
P_jDe'G P -O D .
A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
NUMBER
g /proposed) 1ST FLOOR D / (2L2ND FLOOR —�—
OTHER / BASEMENT FINISHED �'—
PA-na 1 z, cl
- - / GARAGE d
L I, ,coo 110
/
HEIGHT TO PEAK OF BUILDING ;.� l FT.
--- .
2. )
X 9 PLUMBING FIXTURES (Including rough -ins)'
(� NEW CONSTRUCTION —
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY l 131: + -- SQ. FT.
IMPERVIOUS SURFACE — 11Z1 SQ. FT.
MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED P�UMBING / 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-. t
(1 g Water Service meter size if known) Also see BOX 4
< 11 Septic Tank — Not generall allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and t e Health District (See BOX 4)
( 12 Street use may require a " ¢treet Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
RIFY UNDER THE PENALTY OF PE JURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
2RECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
)VE PREMISES TO PERFORM THE ORK FOR WHICH THE APPLICATION IS MADE.
AICA I nrtr.ir <-i'f `J�,'V "^�• � .���� � — ��0�
7cy S. Te, rs4- q
T t.
til i.uy oI apokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard
x. on Date
Print the name of the bolder -MD j-"7
Signature __ ���t1•'�'V�.`� ��L�lii2�iiN�
This document originally contained
__W
leLEE"D NOT WRITE BELOW THIS LINE
— es roye
ZONE SETBACKS:' FRONT SIDE— —
REAR—_—______HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL
DIS
APPROVAL
REMARKS
SEPA: EXEMPT •= '• NOT EXEMPT
---
DATE
ii,�
FIRE DEPARTMENT APPROVAL
DISAPPROVAL DATE
REMARKS —
PUBLIC WORKS DEPARTMENT APPROVAL — — —
DISAPPROVAL
DATE
_______________________________;
TYPE OF JOB: NEW IKESIDENCE RES. ADD/ALT
NEW INDUSTRIAL IND. ADD/ALT_
NEW COMMERCIAL COMM. ALT/ADD
NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT
TENANT IMP. ROOF __OTHER
OCCUPANCY TYPE OF CONSTRUCTION
STORIES
BUILDING SQ. FT. @ —
BUILDING SQ. FT. @ —
BUILDING SQ. FT. p@ —
BUILDING SQ. FT. p@ —
TOTAL SQ. FT. TOTAL VALUATION .
BUILDING PERMIT N.0. PLAN CHECK FEE RECD
RECEIPT NUMBER__
PERMIT FEE
PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES — WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS
Sel�OC s
/41-7)
1r� ,rU `-, e
m
6m,1 ,
1fa
11707 E. SPRAGUE, STE 106
alley SPOKANE VALLEY, WA 99206
(509)688-0036 FAx(509)688-0037
,SITE INFORMATION
Site Address:��
Parcel Number:
Subdivision:
Block: 2 Lot:
Zoning: Water Dist:
Owner: j, S
Address:
Building Inspector:
ffli I EMIT
PLANNING:
ENGINEERS:
PROJECT TRANSMITTAL:
TRANSMITTAL DATE:
PERMIT INFORMATION
Permit Number: 2SIssue Date:
Permit Use: -�% ux�
Applicant:
Contact:
T&
Contractor:
1LeftSetbacks — Front-.;z-
:
APPROVALS
/03
FIRE 14ST.. -
Phone:
Phone:
Right: C'- Rear:,
APPROVALS
WATER 1 I19 :
ATER:
ER:
tot cc)
3
30
)Jt5
_� a0
a�
IzS,4g
1
7I
11a5s,
l5,
LOTIO,BLOL...2.,
s ECT I o N z4, T; Zj5 N.,
N
DRVVE 1 I p'Rivs I A, 2-21
S4,3t
feRST4�-D Lfq
110'
5'
APPROVED BY(E-y
•(
SpCTTYu�k
ane
,,�,�Valley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT � F Lj F_
ADDRESS: 2 Lf S, 7E-fLs
Lj,) .
PERMIT
USE:
X
OWNER
AMOUNT
PHONE (Daytime Contact): q 24 _(P 11, 1
MAILING ADDRESS:
11!Z 1 E
�b
(street)
(city/state)
2 FUEL BURNING APPLIANCE
(ZIP)
CONTRACTOR: ^fits F --i
LICENSE #:
K dZ S
MAILING ADDRESS:
46b5 s, BEs'7• GT,
PHONE #:
VE--4bA-Lr-- I WAt,
el -q —
cfel a
(street)
(city/state)
$50 -
(ZIP)
METHOD OF PAY]
DESCRIPTION OF WORK
x OF LV% TS
X
COST EQUALS
AMOUNT
1 FUEL BURNING APPLIANCE
• OR < 100,000
X
$IS
2 FUEL BURNING APPLIANCE
> 100,000
X
$19 -
3 UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR <400,000
X
$50 -
4 UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100 -
5 USED APPLIANCE (WSEC min. AFUE rating)
. or < 400,000
X
$50 -
6 USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100 -
7 BOILER/REFRIGERATION
1 - 100M BTU
X
$15 -
8 BOILER/REFRIGERATION
101 - 500M BTU
X
$28 -
9 BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39 -
10 BOILER/REFRIGERATION
1001 - 1,750M BTU
X
$57 -
11 BOILER/REFRIGERATION
+1750M BTU
X
$95 -
i2 GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10 -
13 RANGE
-
j
X
$10
14 DRYER
-
%
X
$10 -
0
15 FUEL BURNING WATER HEATER
-
%
X
$10 -
16 MISC FUEL BURNING APPL.
-
X
$10 -
17 GAS PIPING (ea. Outlet)
-
X
$1
19 DUCT SYSTEMS
_
X
$10
')
19 VENTILATING FANS
-
X
$10 -
20 AIR HANDLER (DOES NOT include ducting)
• OR < 10,000CFM
X
$12
21 AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19 -
22 EVAPORATIVE COOLERS
-
X
$10 -
23 TYPE I HOOD
_
x
$50
24 TYPE II HOOD
_
X
$10 -
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
x
$12
26 AIR CONDITIONER
3-15 TON
X
$20
27 AIR CONDITIONER
15-30 TON
X
$25-
28 AIR CONDITIONER
30-50 TON
X
$35
29 AIR CONDITIONER
.50 TON
X
$60 -
30 LPG STORAGE TANK
-
X
$10 -
31 WOOD OR PELLET STOVEANSERT
-
X
$10 -
32 WOOD STOVE - FREE STANDING
-
X
$25
gENT
—
PISA
SUBTOTAL:
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
2-40
$35.00
❑ CASH ❑ CHECK
DATE:
BANKCARD NUNIBER:
AUTHORIZED SIGNATURE:
EXPIRES:
ETHOD OF
CASH
kTE:
rn� ort>� �1,
Spokane
;,,,Walley
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
Plumbing Permit Application
PROJECT Q t.
ADDRESS: 72-1, S, 7Me> )' D L4,,i
PERMIT
USE:
OWNER: (�,eZD SW4�S(C
PHONE (Daytime Contact):
MAILING ADDRESS:
1712- 1 S -r4 AV G �Z--St3 Ac4�s I w A, 2q6 !
(street) (city/state) (ZIP)
CONTRACTOR: , `
I�
LICENSE S: S -S K i P—C -�K 0 Z J'
MAILING ADDRESS: PHONE #: S 1 � — 43540
`+bo5 S' 8L -ST C.T. VE14rDPrt. w A-, (tq o 3 7
(street) (city/state) (ZIP)
PLUMBING FIXTURES
NKCARD NUMBER:
1THORIZED SIGNATURE:
DESCRIPTION
DETAILS
A OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
2
URINALS
X
$6
-
3
TUBS
2
X
$6
-
12-
z4
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
12-
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
/-
w
X
$6
-
3,0
RAY, FOOD, PREP/CULINARY/MEAT
tt
6
DISHWASHER
X
$6
-
17-
7
CLOTHES WASHER
Z
X
$6
-
12-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
INSTALLATION, ALTERATION, REPAIR,
WASTE, VENT, PLUMBING
REVERSALS
X
$6
-
12 -
2REVERSAL
REVERSAL
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER PROOFER, CARBONATOR,
X
$6
-
SWAMP COOLER
16
CROSS CONNECTION DEVICE I
VACUUM BREAKER, CHECK VALVE, AND
t
RP.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
Cp
17
SPRINKLER SYSTEM
X
$25
-
5Q
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
SUBTOTAL:
Z
. `_._.�.__..
CHECK 0
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
cvmnrc_
NKCARD NUMBER:
1THORIZED SIGNATURE: