2004, 03-12 Permit App: BLD-04-03755 Remodel*Thane
44,Ual yk
' n . 7 5
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:
pit s• Die.
da tce- y
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit
Relocation
ki(9 le y krl4-&t
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: Jol I V1 11.e/► I
Phone: 6iFax:
Address:
City
Contractor:
Phone:
State
OC/l
0
❑ Applicant:
Phone:
Address:
Fax:
Zip Code City
Address:
Fax:
City
State
WA State Contractor License #:
Zip Code
State Zip Code
❑ Architect:
Phone: Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2ND FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:/Acea-
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
st�"
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: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City
State Zip Code
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
56.00
=
2
URINALS
X
$6.00
=
3
TUBS
I
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
56.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
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
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, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
* 'a 16 L
per
EMERGENCY EGRESS REOIJIREMENTS
FROM SLEEPING Pr OMS
1) NET CLEAR OPENING 5 7 SQUARE FEET
GRADE FLOOR OPENING 0/1A:•, . , 0 SQUARE FEET
2) NET CLEAR OPENING HFIGH INCHES
3) NET CLEAR OPENING WID1H INCHES
4) MAX FINISHED SILL HEIGHT • s` ABOVE FLOOR
5) EMERGENCY ESCAPE 8 RESCUE C 'i NTNG SHALL BE
OPERATIONAL FROM THE INSIDE OF 1-E ROOM WITHOUT
THE USE OF KEYS OR TOOLS
f, 5 "X+ 5 f:
EXHAUST ctr<eh
FANS
50 00 � athroa s
&, laundry
sr� 4
ALL ctiL
Com- fJ�,
e'n1.4act 2t)
Vrtvl'ulAs0
WHEN INTERIOR ALTERATIONS, REPJf OR ADDITIONS
REOUIRING A PERMIT OCCUR, OR WHEN ONE OR MORE
SLEEPING ROOMS ARE ADDED OR CREATED IN EXISTING
DWELLINGS, THE DWELLING UNIT SQL BE PROD
WITH SMOKE ALARMS LOCATED AS REQUIRED FOR NEW
DWELLINGS,