2004, 06-11 Permit App: BLD-04-04587 ResidenceSii6k00"4,.,1/4an
jUalley
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: \ZRt,t L\cwt
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
,Nr Building Permit ❑ Change in Use ❑ ❑ Grading ❑Manufactured Home
Relocation
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
pi( Owner: ] .1 n*SPJV Core4 Tnc'z JX Applicant:
Phone: o ' 101a Fax: 4R(( Phone: Fax:
Address: pp, p,L a0192 Address:
wPc q°127
City State Zip Code City State Zip Code
Contractor:
Phone:
Address:
❑ Architect:
Fax: Phone: Fax:
Address:
City State Zip Code City
WA State Contractor License #: Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS: SOX (00
# OF STORIES:
MAIN FLOOR TO $0.
FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG: , i , 1
-I�1
DECK/COV. PATIO SQ. FTG:
loO
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE: n_
# OF BEDROOMS: V 7
TOTAL HABITABE,SPACE:
`I'
IMPERVIOUS SURFACE AREA:
.21102..
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM? SeMJPJC
j�
Project Address:
Owner:
Mailing Address:
Contractor:
LINDSEY CONSTRUCTION, INC.
P.O. BOX 30792
SrOr writ, WA YYL13
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
Permit Use:
Phone (Daytime Contact): 11')I3
Mailing Address:
Cay
License #: Phone #:
State
Zip Code
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
if OF
UNITS
X
COST
=
v TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
l
X
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
"X
$19.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More Oran 400,000
X
$100.00
=
5
USED APPLIANCE (WSEC min. AFUE
ra5ng)
Equal to or less than 400,000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE
rating)
Mom than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$26.00
=
9
BOILER/REFRIGERATION
501 -1 000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
557.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
595.00
=
12
GAS LOG, GAS INSERT GAS FIREPLACE
X
$10.00
=
13
RANGE
X
510.00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
`
X
$10.00
=
16
MtSC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each oudet)
2..
x
$1.00
=
18
DUCT SYSTEMS
1
X
$10.00
=
18
VENTILATING FANS
5
X
$10.00
=
20
AIR HANDLER (DOES NOT Include ducting)
Equal to or less than 10,000 CFM
.
X
51200
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10000 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
1
X
512.00
=
26
AIR CONDmONER
3-15 TON
X
520.00
=
27
AIR CONDITIONER
15-30 TON
X
525.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
580.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
525.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA ❑ MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
Project Address:
Owner:
Valley
LINDSEY CONSTRUCTION, INC.
P.O. BOX 30792
SPOKANE, WA 99223
Mailing Address:
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): k3&J 1 DL? -
Contractor. XAme,
Mailing Address:
License #:
City_
State
Phone #:
Zip Code
• city
State
BANKCARDNUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
• • OF
UNITS
X
COST
-
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
X
38.00
=
2
URINALS
X
38.00
=
3
TUBS
X
38.00
=
4
SHOWERS (PER TRAP)
BATH STALL ON-SITE BUILT
X
$8.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
3
X
$6.00
=
PREP/CULINARY/MEAT
6
DISHWASHER
‘
X
$8.00
=
7
CLOTHES WASHER
1
X
$8.00
=
8
GARBAGE DISPOSAL -
1
X
$8.00
=
9
WATER SOFTENER
X
58.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
58.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$8.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
38.00
=
13
FOUNTAINS, DRINKING
X
$800
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
38.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
58.00 •
=
18
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
3
X
$8.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R_P.B.P.D. FOR
VATS TANKS BOILERS
X
-
58.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
58.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
38.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
5800
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
335.00
TOTAL PERMIT FEE DUE:
BANKCARDNUMBER:
AUTHORIZED SIGNATURE:
Zip Code
Proposed Plot Plan
1209 S Lloyd Street
City of Spokane Valley
County of Spokane, State of Washington
WOODLAND TERRACE
SCALE 1:20 I SEWER & WATER PROVIDED BY CITY OF SPOKANE
ADDRESS: I L$1 AI.
ro`tt0
oar 1 i
ZONE: UR 3.5
ROAD WIDTH. 60
FRONT: FLANKING
COMMENTS:
REVIEWED BY:
PLANNING DEPT. APPROVED
BY•_
DATE:
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 identified. Also indicted arc wetlands,
bodies of water, steep slopes or other critical areas.
Lindsey Construction, Inc.
52,4
ChiLCKED AND
APPROVED