2007, 04-27 Permit App: 07001395 ResidenceProject Number: 07071395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/27/2007 Page 1 of 3
Project Information:
Permit Use: SFR
Setbacks: Front 26 Left: 16 Right: 17 Rear: 20
Site Information:
Plat Key:
Contact: BLACKHAWK CORPORATION
Address: 23900 E JOSEPH
C - S - Z: OTIS ORCHARDS, WA 99027
Phone: (509) 226-2186
Group Name:
Project Name:
Name: Range
District: Nort
Parcel Number: 45184.1230 Block:
SiteAddress: 8515 E MAIN AVE
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District: 005 HUTCHINSON
Area: 6,771 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot:
Owner: Name: CONSOLIDATED ESCROW SERVI
Address: 10117 E 16TH AVE
SPOKANE, WA 99206-3457
Hold: 0
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
ReleasedBy:
Driveway/Approach
Originally Released: 4/27/2007 By: TMELBOU
Released By:
Originally Released: 4/27/2007 By: j_davis
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released: 4/23/2007 By: mharnois
Operator: JD
Printed By: JD
Print Date: 4/27/2007
�1 l
Project Number: ' 07001395 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 1 of 3
Project Information:
Permit Use: SFR
Setbacks: Front 26 Left: 16 Right: 17 Rear: 20
Site Information:
Plat Key:
Contact: BLACKHAWK CORPORATION
Address: 23900 E JOSEPH
C - S - Z: OTIS ORCHARDS, WA 99027
Phone: (509) 226-2186
Group Name:
Project Name:
Name: Range
District: Nort
Parcel Number: 45184.1230 Block:
SiteAddress: 8515 E MAIN AVE
Location:: CSV
Lot:
Owner: Name: CONSOLIDATED ESCROW SERVI
Address: 10117 E 16TH AVE
SPOKANE, WA 99206-3457
Zoning: UR -3.5' Urban Residential 3.5
Water District: 005 HUTCHINSON Hold: ❑
Area: 6,771 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs 0 Nbr of Dwellings: 0
Review Information: m
Review
Building Plan Review
Released By: 1-
Driveway/Approach
Released By: - -
Landuse/Zoning/HE Conditions
Released By: -
Sewer Review
Permits:
tReleased*By:3
Operator: JD JD Printed By: JD
Print Date: 4/20/2007
Project Number: ' 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 1 of 3
Project Information:
Permit Use: SFR
Setbacks: Front 26 Left: 16 Right: 17 Rear: 20
Site Information:
Plat Key:
Contact: BLACKHAWK CORPORATION
Address: 23900 E JOSEPH
C - S - Z: OTIS ORCHARDS, WA 99027
Phone: (509) 226-2186
Group Name:
Project Name:
Name: Range
District: Nort
Parcel Number: 45184.1230 Block:
SiteAddress: 8515 E MAIN AVE
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District: 005 HUTCHINSON
Area: 6,771 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Lot:
Owner: Name: CONSOLIDATED ESCROW SERVI
Address: 10117 E 16TH AVE
SPOKANE, WA 99206-3457
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Released By: - -
Driveway/Approach
Released By:
Landuse/Zoning/HE Conditions
Sewer Review
Permits:
'Operator: JD
•
Printed By: JD
Print Date: 4/20/2007
Project Number: 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit -
Date: 4/20/2007 Page 2 of 3
Contractor: BLACKI-IAWK CORP
Address: 23900 E JOSEPH
OTIS ORCHARDS, WA 99027
Building Characteristics
Building Height 21
Descriptionrp
1&2 FAMILY R-3
2ND FLOOR R-3
DECK OPEN
COJ c.w.reAr
GARAGE U-1 VB
Firm: BLACKHAWK CORP
Phone: (509) 226-2186
This Application: Total Project:
Type Notes Sq Ft Valuation Sq Ft Valuation
VB 2fe2— 149 $10,049.60 110 $10,049.60
VB OK 1,120 883,641.60 1,120 883,641.60
R-3 VB 0 1`40 % 81,440.00 96 81,440.00ff,2 Pal
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Contracto
Address:
BLACKHAWK CORP
23900 E JOSEPH
OTIS ORCHARDS, WA 99027
Item Description
GAS WATER HEATER
GAS PIPING
VENTILATING FANS
HOOD - TYPE 1
GAS LOG OR GAS INSERT
$19,190.00 1,010 $19,190.00
Totals: 2,336 $114,321.20 2,336 $114,321.20
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Units
2.
3
1
l
Operator: JD Printed By: JD
Fee Amount
$1,077.75
$4.50
$431.10
$1,513.35
Firm: BLACKHAWKCORP
Phone: (509) 226-2186
Unit Desc
NUMBER OF
# OF UNITS
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$2.00
$30.00
$50.00
$10.00
$102.00
4/20/2007
Project Number: ' 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/27/2007 Page 2 of 3
Building Permit
Contractor: BLACKHAWK CORP Firm: BLACKHAWK CORP
Address: 23900 E JOSEPH Phone: (509) 226-2186
OTIS ORCHARDS, WA 99027
Building Characteristics
Building Height 21
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB 262 $23,936.32 262 $23,936.32
2ND FLOOR R-3 VB 1,120 $83,641.60 1,120 $83,641.60
COV DECK R-3 VB 200 $3,000.00 200 $3,000.00
DECK OPEN R-3 VB 96 $1,440.00 96 $1,440.00
, GARAGE U-1 VB 858 $16,302.00 858 $16,302.00
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW <7999 SQ FT
Totals: 2,536 $128,319.92 2,536 $128,319.92
Units Unit Desc Fee Amount
I SELECT $1,156.15
1 SELECT $4.50
1 SELECT $462.46
Permit Total Fees:
Mechanical Permit
$1,623.11
Contractor: BLACKHAWKCORP Firm: BLACKHAWK CORP
Address: 23900 E JOSEPH Phone: (509) 226-2186
OTIS ORCHARDS, WA 99027
Item Description
GAS WATER HEATER
GAS PIPING
VENTILATING FANS
HOOD - TYPE I
GAS LOG OR GAS INSERT
Units Unit Desc
1 NUMBER OF
2 # OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: JD Printed By: JD
Fee Amount
$10.00
$2.00
$30.00
$50.00
$10.00
Permit Total Fees: $102.00
Print Date: 4/27/2007
Project Number: • 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 2 of 3
Building Permit
Contractor: BLACKHAWKCORP Firm: BLACKHAWK CORP
Address: 23900 E JOSEPH Phone: (509) 226-2186
OTIS ORCHARDS, WA 99027
Building Characteristics
Building Height 21
This Application: Total Project:
Description Grp Type Notes So Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB 110 $10,049.60 110 $10,049.60
2ND FLOOR R-3 VB 1,120 $83,641.60 1,120 $83,641.60
DECK OPEN R-3 VB 96 $1,440.00 96 $1,440.00
GARAGE U-1 VB 1,010 $19,190.00 1,010 $19,190.00
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 2,336 $114,321.20 2,336 $114,321.20
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,077.75
$4.50
$431.10
$1,513.35
Contractor: BLACKHAWK CORP Firm: BLACKHAWK CORP
Address: 23900 E JOSEPH Phone: (509) 226-2186
OTIS ORCHARDS, WA 99027
Item Description
GAS WATER HEATER
GAS PIPING
VENTILATING FANS
• HOOD -TYPEI
GAS LOG OR GAS INSERT
Units Unit Desc
1 NUMBER OF'
2 # OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: JD Printed By: JD
Fee Amount
$10.00
$2.00
$30.00
$50.00
$10.00
Permit Total Fees: $102.00
Print Date: 4/20/2007
Project Number: 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 3 of 3
Plumbing Permit
Contractor: BLACKHAWK CORP Firm: BLACKHAWK CORP
Address: 23900 E JOSEPH Phone: (509) 226-2186
OTIS ORCHARDS, WA 99027
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Units Unit Desc
2 NUMBER OF
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$18.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$72.00
Notes•
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$1,513.35
$102.00
$72.00
Invoice Amount
$1,513.35
$102.00
$72.00
$1,687.35 $1,687.35
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$1,513.35
$102.00
$72.00
$0.00 $1,687.35
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: JD Printed By: JD Print Date: 4/20/2007
Project Number: 07001395 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/27/2007
Contractor: BLACKHAWKCORP
Address: 23900 E JOSEPH
OTIS ORCHARDS, WA 99027
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Notes-
Payment
otes
Plumbing Permit
Page 3 of 3
Firm: BLACKHAWK CORP
Phone: (509) 226-2186
Units Unit Desc
2 NUMBER OF
3 NUMBER OF
1 NUMBER OF
I NUMBER OF
I NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF ,
Permit Total Fees:
Fee Amount
$12.00
$18.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$72.00
Payment Summary.
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount
$1,623.11
$102.00
$72.00
$1,623.11
$102.00
$72.00
$1,797.11 $1,797.11
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$1,623.11
$102.00
$72.00
$0.00 $1,797.11
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD Print Date: 4/27/2007
Permit Center
Scm a 11703 E Sprague Ave, Suite B-3
pokane , GSpokanejairYe 99206(
(So9)688Eoo36 IFAX:(509)688-0037
ValleynI J
wwwspokanevallev.ore i �
Community Development CR 1 " 'ItQ]
Residential Cori 1 uction (- ❑ New Construction
Permit Application) d f1 [ f. k ❑ Addition/Remodel
❑ Other:
PERMIT NUMBER: B9 S
PERMIT FEE:
Accessory Bldg
❑ Deck
SITE ADDRESS:
g$/.9 E; /tM /iV
ASSESSORS PARCEL NO:
ys j f 9<iz3/LEGAL DESCRIPTION: Col" 3'
Build.in Owner:•.
g ���C/coif=��'it! �C/IiP�`�•r/e.
Cotractor:.: ,
� ..�.z ,� �,l%%!/>49es/(!Gire;.°:�`,r%"
Name:
Name: /76Bis- 'r f'cg/ ar,r ,,,„ y
C
Address: pf�
Address: ,4 (4'7 �„
..7-
2- ? .� n J fe-
City: State: Zip:
City: j_/S . 0�r,4?01. State: �� Zip:9962'1
Phone: Fax:
Phone:2 ate( l Fax:
ZzC— 22(--27/s
30% SLOPES ON
PROPERTY: 0
Contractor Lic Date: 7 / j,-
C/eGZ DxU
No:�G
"
_ContacfPersii.•., . .. ..., ,City
HEAT SOURCE:
CAC ¥Stec .
Business Lic. No:
Name: gy+ijfl7 Se4',-fld-t /Jy
Phone: 416 9 --O.7 ge c.
Describe the scope of work in detail:
Cost of Project: $ / w 1,.'c7
Noeterte
Proposed Use: /f/k217 n g,er r e
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
21 t
DIMENSIONS:
32x Jr
# OF STORIES:TOTAL
.z
HABITABLE SPACE:
/71a -IV /_ ;
MAIN FLOOR TO SQ.
FTG:
/70
2"" FLOOR SQ. FTG:
// ZO -
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
/72-0 .
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:
/-016)
DECK/COV. PATIO SQ. FTG:
9G
30% SLOPES ON
PROPERTY: 0
# OF BEDROOMS:
3
CONSTRUCTION TYPE:
Eain`A .
HEAT SOURCE:
CAC ¥Stec .
SEWER OR SEPTIC?
_recd. e..
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) 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 be processed.
SIGNATURE: ,! , � �J DATE: .>
Method of Payment:
❑ Cash Check ❑ Mastercard ❑ VISA
Bankcard #: / \ Expires: VIN#:
Authorized Signature:
REVISED 2/15/07
Spokane
#Valley
11703 E Sprague Ave Suite 8-3 • Spokane Valley WA 99206
509.688.0036 • Fax: 509.688.0037 • cityhall@spokanevalley.org
Residential Plan Submittal Minimums
C� Completed Building & Mechanical application with: Accurate address, Parcel
Number and/or Legal Description, description of work, owner and contractor
information, signature, and date.
l- Two sets of plans including Site Plan, elevations, floor plans, foundation plans
With details, roof plan; framing plans& details.
a Show the height of any proposed buildings or accessory structures.
E- Floor plan for each floor: Dimension to scale (minimum 1/8") and label each
Room (including sq. footage of house and garage on plans) Show each
level of existing house and square footage of any additions.
o� All braced wall panel types: show locations and details of installation, including
engineered design.
LY Egress windows: Provide at least one window or exterior door approved for
Emergency escape or rescue from a basement and in every room for sleeping.
i – Smoke detector locations
R 22" X 30" attic access location
❑ 18" X 24" crawl space access:
0-- One-hour separation detail: between house and garage
0,- Floor framing details: Joist type, size, spacing and installation details
▪ Roof framing plan and details
❑ Furnace and hot water heater location.
❑ All header locations: type, size, and connections
Lha Foundation plan
C9� Insulation information
Spo"kan�
cossarValley
Community Development
!lambing Permit Application n Commercial
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokan eval I ey.or2
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
SITE ADDRESS: B-1,9 Lam\ _ �-94 (/V
Building ON ner AZ -a e.''��-€'Ke CAfO ' ...771,7- . '
Name: Phone: Fax:
Z.1C_ ancr
e0/l r- Cc „ye „s4c z -i C'- L/ drC
Address: Z3��339-pyo e . re?�'f/ City':0 y O/ *(7644r7FkiY State:
(l�1
Zip: 50%/2 --,Contractor
/jZ,Lc �l Q4-. ,4l/, ec
ciy
_Av
! /�
Name- Phone: Fax:
Address: S`deb-!L! e City- State:
Zip:
License No: /M -ec 4062t,y City Business Lic:
'Contact 6ii7; .::4"CfrV-toesa it y
Name: - Phone: g 6 9 _et? 9 s'
DESCRIPTION OF WORK
#OF UNITS X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
Z
X
$6 00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
E
4
SHOWERS (PER TRAP) .
BATH, STALL, ON-SITE BUILT
/
X
$6 00
H
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
5,
X
$6.00
If
6
DISHWASHER
/
X
$6 00
6
7
CLOTHES WASHER
X
$6 00
G
8
GARBAGE DISPOSAL
/
X
$6.00
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
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
6
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 DISPOSAL/SYS
X
$20 00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
DCASH Al CHECK D VISA DMC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES'
VIN.
SUBTOTAL
9.1,E
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
r..
Spo`kan` e\':'
cValley
Permit Center
. 11707E Sprague Ave, Suite 106
Spokane Valley, WA 99206
• (509)688-0036 FAX: (509)688-0037
Community Development www.spokanevatlev ore
Mechanical Permit Application ❑ Commercial
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
SITE ADDRESS: Ps /J 4_ • 41/4 t/47.
Building Oww�•ner- /JJg(.�#CZ7,u,. r cern,cern,r�r
f;,,.
Name: ,io c?' - £'c met ,oi,F/r/
Phone: -ZaC-_ Zi e' Fax: 226-
2 5/7.
-Address 2 3 4 eo se- rel iv/°%/_
City: OT/‘" age..mir'( State: tve eit
Zip: 97 7 /_'0Z7
ct
Contraor, _ AL„,ky - .v,,,,G'X 4'P.:
..
Name: GQe nr- g Cne/LO•7047W,IC.
Phone: t6, - 0' 4 ej Fax:
Address: z 3l`n e - ci"OiYI%e
City err, B 4 cy*tt4#f State: 1.4....✓4.
Zip: etccei 1
License No:11.C/,I0tYiD G 2 p if
City Business Lic:
--
Contact- -
Phone:.
,-%'�
Name: 746 w T 7 C i? tee re* /ttr
DESCRIPTION OF WORK
#OF UNITS X
COST
= TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
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
13
RANGE
X
$10.00
14
DRYER
X
$10.00
15
FUEL BURNING WATER HEATER
X
$10.00
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
17
GAS PIPING (each outlet)
X
$1 00
'2-
18 18
DUCT SYSTEMS
X
$10.00
19
VENTILATING FANS
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
3
X
$10.00
X
$12.00
go
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
10.
24
TYPE II HOOD
X
$10.00
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
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
$60.00
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
$19.00
37
INCINERATOR - COMMERCIAL
X
$22.00
METHOD OF PAYMENT:
DCASH ❑ CHECK ❑ VISA 0 MC
CARD #.
AUTHORIZED SIGNATURE:
REVISED 826'03
EXPIRES
VIN:
SUBTOTAL
/0L, �(1
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
/ J7r rU
05/02/2007 WED 12:47 FAX 509 926 1519 TRANSNATION
TRANSNATION TITLE INSURANCE COMPANY
105 WEST 3R11 AVENUE
SPOKANE, WASHINGTON 99201
(509) 922-2222 / FAX 926-1519
PREPARED FOR:
Building Code Department
RE: Blackhan k Corporation
There are 2 pages including this page
Vesting decd for Li 3 Document # 5527770 recorded April 26, 2007
bated May 2, 2007
TRnNSNAT1ON TITLE, INSURANCE COMPANY
From: Michelle Elwin, Title Officer
MAY 02 2,007 13:53
m001 002
509 926 1519 PRGE.01
05/02/2007 ICED 12:47 FAX 509 926 1519 TRANSNATION
41)02/9Z/.
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AFTER RECORDING MAIL TO:
Walde, Schweda a Montgomery, P,5.
2206 N. Pines Road
Spokane, WA 99206
1111 IIIe III III! m o II IIIIIII III
TBR4$H , nn
'7
11111 552,7770
Ne: t of
KI 05 Sockane8Co, 57 63;42FI
STATUTORY WARRANTY DEED
Escrow No. 2007046
Title Order No. 20301011
THE GRANTOR(S) Marc R. Roecks, As His Separate Property
for and in consideration of Ten Dollars and other good and valuable consideration
In hand paid, conveys, and warrants to Blackhawk Corporation, Inc., A Washington Corporation
the folioti ng oescrlbed rest estate, situated In the County of Spokane, State of Washington:
Lot 3 of CITY OF SPOKANE SHORT PLAT 39-05 as per plat thereof recorded In Volume 22 of Short
Plats, Pages 3 and 4, and Altered Pages 3A and 4A;
Situate in the City of Spokane Valley, County of Spokane, State of Washington.
Tax Parcel Number(s): 45164.1231
Subject to: General Property Taxes. Liability for future charges levied by the City of Spokane
Valley. Easements, restricitions, reservations, covenants, provisions and agreements of record.
Dated: April 19, 2007
Marc R,'Rcecks
STATE OF Washington
Ss.
COUNTY OF Spokane
I certify that t knew ar have satisfactory evidence that Marc R. Roecks Is the person who appeared
before me. and sail person acknowledged that he signed this Instrument and acknowledged it to be his
free and wluntary act for the uses and purposes mentioned in this instrument.
Gated: r�.�vd�y c! April. 2007
NotaryPuo! iryaryd<u�rtnsi't�1tic�of
Washingto,. re mhg at Spokane
My Commis Expires: /o -0j- f
MAY 02 2007 13:53
LPO IO OS
509 926 1519 PAGE.02
002/002
1 =.Q
Method III Worksheet for Fresh & Combustion Air
Job Address:
Furnace model #: -
Furnace brand name: BTU input:
Water heater brand name: BTU input:
Install Foreman: j-
1
Ventilation Rate Determination
Floor area (sq. ft.) of the residence (basement + 1st floor + 2nd floor + bonus room) _
Number of bedrooms in the residence =
Using the table on the back of this form determine:
Minimum Ventilation Air = CFM
Maximum Ventilation Air CFM
Formula for Combustion Air
1 - For fan assist vented furnace x 1,000 BTU input x .4 CFM/BTU = CFM
2 - Power vented water heater (use 90 CFM if rating unknown) = CFM
3 - For draft hood appliances x 1,000 BTU input x .8 CFM/BTU = CFM
Total CFM Required for Combustion Air (add 1+2+3)
The ventilation/combustion air duct must provide adequate combustion air or outside combustion air must be provided
separately from ventilation air. (Outside combustion air may be provided with one duct in the upper 12 inches of the enclosure
sized at 1 sq. inch per 3,000 BTU input of all appliances in the enclosure).
6"= 50- 80
7" = 80 - 125
8"=115-175
Capacity of Round Metal Duct in CFM
9" = 170 - 240
10"=235-315
12"=395-495
Size of round duct
to return air drop =
1. For lengths over 20 feet increase the duct diameter 1 inch.
2. For elbows numbering more than 3, increase the duct diameter 1 inch.
3. Insulate the ventilation/combustion air dud within the conditioned space to a minimum R-4.
Size of opening in wall of appliance enclosure (if confined space less than 50 cubic feet per
1000 BTU input) per U.M.C. and INWHVAC Assoc. standards book (2 openings sized 1 sq. in.
per 1000 BTU input of all appliances in the enclosure) = square inch
(net free area = 65% for metal louver - 25% for wood louver)
Verification of proper drafting?
Verified by:
Company name:
YES
License #
NO
Leave copy of this form on the job site at' or on the furnace!!!
CFM
Updated 7-1-2001
Ventilation rates for all group R occupancies 4 stories and less*
** For residences that exceed 8
bedrooms, increase the minimum
requirement listed for 8 bedrooms
by an additional 15 CFM per bedroom.
The maximum CFM is equal to 1.5
times the minimum.
Bedrooms
Area ft2
2 or less
3
4
5
6
Min.
Min.
Max.
Min.
Max.
Min.
Max
Min.
Max.
Min.
Max.
<500
50
75
65
98
80
120
95
143
110
_165
501-1000
55
83
70
105
85
128
100
150
115
173
1001-1500
60
90
75
113
90
35
105
158
120
180
1501-2000
65
98
80
120
95
143
110
165
125
188
2001-2500
70
105
85
128
100
150
115
173
130
195
2501-3000
75
113
90
135
105
158
120
180
135
203
3001-3500
80
120
95
143
110
165
125
188
140
210
3501-4000
85
128
100
150
115
173
130
195
145
218
4001-5000
95
143
110
165
125
188
140
210
155
233
5001-6000
105
158
120
180
135
203
150
225
165
248
6001-7000
115
173
130
195
145
218
160
240
175
263
7001-8000
125
188
140
210
155
233
170
255
185
278
8001-9000
135
203
150
225
165
248
180
270
195
293
>9000
145
218
160
240
175
263
190
285
205
308
** For residences that exceed 8
bedrooms, increase the minimum
requirement listed for 8 bedrooms
by an additional 15 CFM per bedroom.
The maximum CFM is equal to 1.5
times the minimum.
Bedrooms
Area ft2
7
8
Min.
Max.
Min.
Max.
<500
125
188
140
210
501-1000
130
195
145
218
1001-1500
135
203
150
225
1501-2000
140
210
155
233
2001-2500
145
218
160
240
2501-3000
150
225
165
248
3001-3500
155
233
170
255
3501-4000
160
240
175
263
4001-5000
170
255
185
278
5001-6000
180
270
195
293
6001-7000
190
285
205
308
7001-8000
200
300
215
323
8001-9000
210
315
225
338
>9000
220
330
235
353
** For residences that exceed 8
bedrooms, increase the minimum
requirement listed for 8 bedrooms
by an additional 15 CFM per bedroom.
The maximum CFM is equal to 1.5
times the minimum.
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