2004, 06-11 Permit App: BLD-04-04592 ResidenceSpokane
Valley
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax:- (509) 688-0037
REQUIRED SITE INFORMATION
Street Address
2.02 ¶flX-Htm I_ Amick
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit n Change in Use n Grading
Relocation fl Tenant Improvement Fire Safety
Manufactured Home
Other
OWNER/APPLICANT INFORMATION
Owner: L:tset
Phone:
Address: P.n. t X X192
n
c
pc
Contractor:
Phone:
State
Sa irr e ,
Zip Code
Address:
Fax:
City
State
Zip Code
Applicant:
Phone:
Address:
sem.
Fax:
City
❑ Architect:
Phone:
Address:
State Zip Code
Fax:
City
WA State Contractor License #: Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS: _it x' Loo
# OF STORIES: \
MAIN FLOOR TO` Q. TG:
i 1'
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG: 440
DECK/COV. PATIO SQ. FTG:
MD
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE: /�
etas
# OF BEDROOMS: 3
TOTAL HABITABLE ACE:
IMPERVIQ $U FACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? sewe y
Spokane
eioDalley
Project Address:
Owner: l \r%
Mailing Address
Contractor:
12Q 9 U o\,
Const- Z
Mailing Address:
a.
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): G)14pely tOl3
c
State
Phone #.
Zip Code
AUTHORIZED SIGNATURE
Zip Code
Iry State
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
`
X
515.00
2
FUEL BURNING APPLIANCE
More than 100.000
X
$19.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100 00
5
USED APPLIANCE (WSEC min. AFUE
rating)
Equal to or less than 400,000
X
$50.00
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
$70000
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528.00
=
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
X
$10.00
=
13
RANGE
X
$10,00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
I
X
$10.00
=
16
MISC FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
2..
X
51.00
=
18
DUCT SYSTEMS
1
X
$10.00
=
19
VENTILATING FANS
5
X
510.00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
512 00
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I -100D
X
$50.00
24
TYPE It HOOD
X
$10.00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
1
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
$20 00
27
AIR CONDITIONER
15-30 TON
X
525.00
=
28
AIR CONDITIONER
30-50 TON
X
535.00
=
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
X
525.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD#.
SUBTOTAL
DATE:
PROCESSING FEE
535.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE
Zip Code
S`po`kane
Valley
Project Address: \gni *-t* n i -VV ck.
Owner` \.._\r�� F-5-elConk ---7-An r.1
Mailing Address: 2.0 • 'Sox, 1cv2_
Contractor: �CtY114
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
Permit Use:
Phone (Daytime Contact):
Mailing Address:
c%fX n&_ WA- crt21?)
State Zip Code
License #: Phone #:
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
Z.
X
$6.00
=
2
URINALS
X
56.00
3
TUBS
7
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
$6.00
=
6
DISHWASHER
1
X
56 00
=
7
CLOTHES WASHER
\
X
56 00
=
8
GARBAGE DISPOSAL
I
X
$6.00
=
9
WATER SOFTENER
X
$600
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6 00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
=
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
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
3
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER. CHECK
VALVE, AND R.P.B P.D. FOR:
VATS. TANKS, BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SANDTRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56 00
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE. EXPIRES:
SUBTOTAL
PROCESSING FEE
536.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
Proposed Plot Plan
1202 So. Lloyd Street
City of Spokane Valley
County of Spokane, State of Washington
SCALE 1:20 I SEWER & WATER PROVIDED BY CITY OF SPOKANE
72
N
kB
N
y8
ADDRESS. I ga .1.,, o(S�(
ZONE. UR 3.5
ROAD WIDTH: 60
FRONT: FLANKING
COMMENTS:
REVIEWED BY:
PLANNING DEPT. APPROVED
BY
DATE: 3"
The site plan is being submitted for the purpose of
Obtaining a building permit and is a true and correct
Representation of the proposal. All known property
Lines/dimensions, curb lines, structures and easements
have been idrntilirit /Inn unfitted III r wetl,uuln,
bodies of water, steep slopes or other critical areas.
Lindsey Construction, inc.