2006, 05-09 Permit App: 06001124 ResidenceProject Number: 06001124 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/9/2006 Page 1 of 3
Project Information:
Permit Use: SINGLE FAM RESIDENCE, GAS HEATED ON
SEPTIC
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
Parcel Number: 55073.1032
SiteAddress:
1IC\O\ ,L
Location:: CSV
Zoning: UR -3.5
Water District:
Blo
Angiazimaisigimmpok
Contact: GRIGSBY, JOSH
Address: 14809 E 10T AVE
C - S - Z: SPOKANE VALLEY, WA 99016-8512
Phone: (509) 953-8456
Group Name:
Project Name:
Lot:
er: Name: GRIGSBY, JOSH
ddress: 14809 E 10T AVE
SPOKANE VALLEY, WA 99016-85
Urban Residential 3.5
Area: 176,100 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
District: East
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Relea
Driveway/Approach
Originally Released: 5/5/2006 By: TMELBOU
Released
Originally Released:
Septic Sys Review
5/9/2006 By: amblake
Rel
as
y
Originally Released:
Landuse/Zoning/HE Conditions
Permits:
Operator: AMB
5/9/2006 By: amblake
Released By:
Originally Released: 4/3/2006 By: Mharnois
Printed By: AMB
Print Date:
5/9/2006
Project Number: 06001124
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/9/2006 Page 2 of 3
Contractor: OWNER
Item Description
APPROACH -CONST IN ROW
Contractor: OWNER
Description Grn Ing Notes
1&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
BASEMENT F R-3 VB
BASEMENT U R-3 VB
DECK OPEN R-3 VB
GAR WOOD U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Contractor: OWNER
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS
CLOTHES DRYER
RANGE
GAS LOG OR GAS INSERT
HOOD -TYPE II
Approach
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$50.00
$50.00
Firm: OWNER
Phone: (000) 000-0000
This Application:
Sq Ft Valuation
734 $63,395.58
741 $55,337.88
508 $10,160.00
687 $10,305.00
168 $2,520.00
766 $14,554.00
Total Project:
Sq Ft Valuation
734 $63,395.58
741 $55,337.88
508 $10,160.00
687 $10,305.00
168 $2,520.00
766 $14,554.00
Totals: 3,604 $156,272.46 3,604 $156,272.46
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,312.95
$4.50
$525.18
$1,842.63
Firm: OWNER
Phone: (000)
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: AMB Printed By: AMB
Permit Total Fees:
Print Date:
000-0000
Fee Amount
$10.00
$12.00
$3.00
$12.00
$30.00
$10.00
$10.00
$10.00
$10.00
$107.00
5/9/2006
Project Number: 06001124
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 5/9/2006 Page 3 of 3
Contractor: OWNER
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER PIPING - DWV
Notes:
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Plumbing Permit
Firm: OWNER
Phone:
Units Unit Desc
3 NUMBER OF
6 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
3 NUMBER OF
Permit Total Fees:
Fee Amount
$50.00
$1,842.63
$107.00
$108.00
Invoice Amount
$50.00
$1,842.63
$107.00
$108.00
(000) 000-0000
Fee Amount
$18.00
$36.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
$0.00
$108.00
Amount Owing
$50.00
$1,842.63
$107.00
$108.00
$2,107.63 $2,107.63 $0.00 $2,107.63
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: AMB Printed By: AMB Print Date: 5/9/2006
PARCEL NUMBER
'L SITUS ADDRESS CHANGE AUTHORIZATION FORM
SPOKANE COUNTY ASSESSOR'S OFFICE
)0
Ltr&kl
NI
REQUESTED BY:
(Please Print)
OWNER NAME: C�-�St- r i-tC(
DATE OF REQUEST: Si (c /0(0 0
Middle
REQUESTER'S PHONE NUMBER: 5 9. 1P<A6- dv 31
PLEASE PROVIDE DESCRIPTION OF REAL PROPERTY ON REVERSE SIDE
OLD SITUS ADDRESS: 1�bJ e.,
NEW SITUS ADDRESS: tgbj Jbn_4 r
flrel,
AUTHORIZING SIGNATURE:
BUILDING / PLANNING APPROVAL:
OFFICIAL USE ONLY
ASSESSOR OFFICE INITIALS:
Project Number: ,06001124 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/31/2006 Page 1 of 2
Project Information:
Permit Use: SINGLE FAM RESIDENCE, GAS HEATED ON
SEPTIC
Setbacks: Front
Site Information:
Plat Key:
Left: Right: Rear:
Name: Range
Contact: GRIGSBY, JOSH
Address: 14809 E 10T AVE
C - S - Z: SPOKANE VALLEY, WA 99016-8512
Phone: (509) 953-8456
Group Name:
Project Name:
District: East
Parcel Number: 55073.1032
Block:
SiteAddress: 17803 E MISSION AVE
Location:: CSV
Zoning: UR -3.5
Water District:
Area: 176,100 Sq Ft
Urban Residential 3.5
Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot:
Owner: Name: GRIGSBY, JOSH
Address: 14809 E 10T AVE
SPOKANE VALLEY, WA 99016-85
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Driveway/Approach
Septic Sys Review
c
Released
Landuse/Zoning/HE Conditions
Permits:
Contractor: OWNER
Approach
Firm: OWNER
Phone: (000) 000-0000
Operator: AMB Printed By: AMB Print Date: 3/31/2006
4
.Spokane
,., Valley
Community Development
Permit Center
11707E Sprague Ave; Suite 106
Spokane Valley, WA 99206 MAF 3 20
(509)688-0036 FAX: 09)688-0037
spokarevalley. o
Residential Construction
Permit Application
PERMIT NUMBER:0(l?l-
PERMIT FEE:
iNew Construction
❑ Addition/Remodel
o Other:
o Accessory Bldg
❑ Deck
SITE ADDRESS
1110 Mit tIalat.,0
ASSESSORS PARCEL NO: 55 0 73. 10 3 L LEGAL DESCRIPTION:
Building owner/
DIMENSIONS:
75' IVA 39'R,.
Name: 0 ..,► A 2. ,
TOTAL HABITABLE SPACE:
Name: JOSL 6-,; °Sby
2"" FLOOR SQ. FTG:
7 `(1 o (4—V0
City:
Zip:
Address: ) y (0‘; q E, I of
Fax:
Lic No:
Exp. Date:
City: SPc,K:‘n e VA Ile y
Zip:
9 9 1
3!
Phone: q ,j 3S(S 6 Fax:
S91
- 0 0
7 0
Contact Person'.
Name: J cS 4. G ; ; 3s 1:.›).
Phone: q j 3 x -f S
Describe the scope of work in detail:
Ae i1 k.10.1Q
Contractor
DIMENSIONS:
75' IVA 39'R,.
Name: 0 ..,► A 2. ,
TOTAL HABITABLE SPACE:
Address:
2"" FLOOR SQ. FTG:
7 `(1 o (4—V0
City:
Zip:
Phone:
Fax:
Lic No:
Exp. Date:
City Business Lic No:
CONSTRUCTION TYPE:
w Q.:6r6 r (
Cost of Project:
$ 141S. 0Jo
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
Zq
DIMENSIONS:
75' IVA 39'R,.
1
# OF ST RIES:
I ,9Z2.,760'
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
7 ?J �l o�
2"" FLOOR SQ. FTG:
7 `(1 o (4—V0
UNFIN BASEMENT SQ. FTG:
/ `
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG: _S-08 ' l�lz—
GARAGE SQ. FTG:
0 !`
DECK/COV. PATIO SQ. FTG:
1c -,g ' o cam.
30% SLOPES ON
PROPERTY: 0
# OF BEDROOMS:
.....,.-�....__
CONSTRUCTION TYPE:
w Q.:6r6 r (
HEAT SOURCE:
6-,,., 1::)( A.
SEWER OR SEPTIC?
-SQ. p+,
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done
in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Permit Center 5) Thi City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or rdinanc . 6) Pahs or additional information may be required to be submitted, and subsequently approved before
this application canoces ed. / /
Signature
% Date
Method of Paymei/�t (Faxed pe mit applications will only be accepted with major bankcard)
0 Mastercard 0 VISA
Bankcard #: Expires: VIN#:
0 Cash 0 Check
Authorized Signature:
REVISED 8/25/2005
3-7 o oG
0 Other
Spo"k�n" e�
��Va11ey .
Community Development
Permit Center
11707 E Sprague -Ave, . Suite 106
Spokane Valley, WA 9'9206
(509)688-0036 TAX: (509)688-0037
w«w.snokanevallev%ora
Mechanical Permit Application
SITE ADDRESS:
APR
er
PERMIT NUMBER:
PERMIT FEE:
ih kResidential
Building Owner
11 ky
Name: ,10,... t`
.. , S ti tPhone:
5 ,-,q-
15 3 . ‘6,-(-(,_
Fax:
,,;q ..co I - O 7 0
Address: i 1 vC %
E. 1 cit ,,
City: Sp,.&t.e
Vk Ile /
State:
w A Zip: (1 a1 c, s7
Contractor,...
Name: S cue
u.$ G w ne /
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:C
Jt�-
(yE.hY
Phone: -
Sc�
�?S3 �� / ,S
DESCRIPTION OF WORK
# OF UNITS
X
COST
= TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
x
$12.00
12.E
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
3
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
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
$100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
K'.cjO
13
RANGE
X
$10.00
1o, 0(4
14
DRYER
X
$10.00
10 .0
15
FUEL BURNING WATER HEATER
X
$10.00
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
17
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 ducting)
Greater than 10,000 CFM
X
$15.00
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE I HOOD
X
$50.00
24
TYPE II HOOD
X
$10.00
lO.CO
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
kr)
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
560.00
30
LPG STORAGE TANK
X
$10.00
31
WOOD OR PELLET STOVE/INSERT
x
$10.00
32
WOOD STOVE - FREE STANDING
X
$25.00
33
REPAIR & ADDITIONS
X
$15.00
34
VENTILATION SYSTEMS
X
$12.00
35
VENTILATION MECHANICAL EXHAUST
x
$12.00
36
INCINERATOR - RESIDENCE
X
519.00
37
INCINERATOR - COMMERCIAL
X
$22.00
METHOD OF PAYMENT:
❑CASH 0 CHECK 0 VISA 0 MC
CARD #:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
47.0's
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
1 3 L. . t7
spo°kan a •.•
� . Mi11ey
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
t1ww. spok an ev al l e y. ora
Plumbing Permit Application
❑ Commercial
PERMIT NUMBER:
PERMIT FEE: •
Residential
SITE ADDRESS: 0
Building Owner
Name: O.,S 1''
3
,� y
�r , S b
Phone: j Ci - �)
3 " vis- b
Fax:
s0... i -u070
Address:
1'iv3
.�, 13��
City:i
SPcY.a..z
VI
State: w�1-
Zi p:4Qvj?
Contractor
Name: s c Z.
,I
.f,, ? i
‘,..Ai,
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
6
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
$8.00
8
GARBAGE DISPOSAL
X
$6.00
.CL)
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
1
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
NSTALLATION, 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
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
o
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
3. 00
p galley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Approach Permit Application
PERMIT NUMBER:
PERMIT FEE:
PROJECT ADDRESS
START DA IE
ANTICIPA 1'ED COMPLETION DA 1'h
Building Owner:
Contractor:
Name: )L
Address: I '-t Cs C 4 E. 10 t�
Name: Si ^.-e- S let
City:.pc VKltt
State:..' /a Zip: ' (1 v .�
Phone:
,‘'1S (o
Fax: 5-0 - c o ;
Contact Person
Name: Sc✓^Z
Phone:
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions
Address:
City:
State: Zip:
Phone: Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Commercial/Industrial Driveway
Rural Road Section
Sidewalk Repair/Construction
Bond/Insurance certification must be on file with the city.
DISCLAIMER
The permittee verifies, acknowledges and agrees by their signatures that: 1) If this permit is for construction of or on a dwelling, the
dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The
signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in
full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane
Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws,
codes or ordinances. 6) Plans or additional information may be required to be submitted, and subsequently approved before this
application can b processe
Signature
Method of Payment:
❑ Cash ❑ Check
Bankcard #:
Authorized Signature:
REVISED 39/06
Date 6
❑ Mastercard 0 VISA
Expires: VIN#:
MAY J5 2006 15:36 FR
Project Nu3nt e : " 06001124 Inv: 1
Application
THIS IS NOT A PERMIT 84--q/L)
Penalties will be assessed for commencing work without a permit
TO 3241567 P.01/04
Date: 3/31/2006 Page 1 of 2
Proiect Iz f n nation:
mannosnarnannomoinamwmawan
Permit Use: S INGLE FAM RESIDENCE, GAS HEATED ON Contact: GRIGSBY, JOSH
SEPTIC Address: 14809 E 10T AVE
C - S - Z: SPOKANE VALLEY, WA 99016-8512
Setbacks :1'r 3nt Left:
Site Inform a tion:
Plat Ke;
Right:
Rear:
Phone: (509) 953-8456 -
Group Name:
Project Name:
District: East
Name: Range
Pari:e? Number: 55073.1032
Block:
Lot:
it eAddress: 17803 E MISSION AVE Owner: Name: GRIGSBY, JOSH
Address: 14809 E 10T AVE
SPOKANE VALLEY, WA 9901645
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: 176,100 Sq Ft
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Ir1nmation:
Width: 0
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Revi t
Bu ilii tg Pian Review
Priv ray/Approach
Sept c Sys Review
La mit se/Zoning/i1E Conditions
Permits: ,.
Contractor: OWNER
Approach
Firm OWNER
Phone: (000) 000-0000
Opera or: AMB Printed By: AMB Print Date: 3/31/2006