2008, 12-11 Permit App: 08004689 DuplexProject Number: 08004689 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/11/2008 Page 1 of 4
Project Information: -
Permit Use: NEW DUPLEX
Setbacks: Front Left:
Site Information:
Right: Rear:
Contact: POUL CONSTRUCTION
Address: 18902 E 2ND AVE
C - S - Z: GREENACRES, WA 99016 -
Phone: (509) 979-5872
Group Name:
Project Name: 80M MN®'
Plat Key: Name: Range
District: Nort
Parcel Number: 45164.0339 Block:
SiteAddress: 11809 E MAIN AVE
Location:: CSV
Zoning: R-3
Water District: 011
SF Res District
MODERN
Area: .00 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Lot:
Owner: Name: BURLAKOV, PAVEL
Address: 18902 E 2ND AVE
GREENACRES, WA 99016 -
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review Information:
Review
Building Plan Review
Released By:
Originally Released:
Landuse/Zoning/HE Conditions
12/8/2008 By: tmelbourn
Released By:
Sewer Review
Originally Released: 12/5/2008 By: mpalaniuk
Released By:
Originally Released: 12/11/2008 By: jdavis
Permits:
Operator: jmm
Printed By: jmm
Print Date: 12/11/2008
Project Number: 08004689 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/11/2008 Page 2 of 4
Contractor: POUL CONSTRUCTION
Address: 18902 E 2ND
GREENACRES WA 99016
Item Description
APPROACH -CONST IN ROW
Contractor: POUL CONSTRUCTION
Address: 18902 E 2ND
GREENACRES WA 99016
Description Grp Type
1&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
BASEMENT U R-3 VB
COV DECK R-3 VB
DECK OPEN R-3 VB
GARAGE U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Operator: jmm
Notes
Approach
Firm: POUL CONSTRUCTION
Phone: (509) 979-5872
Units Unit Desc
I NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$50.00
$50.00
Firm: POUL CONSTRUCTION
Phone: (509) 979-5872
This Application:
Total Project:
Sq Ft Valuation Sq Ft Valuation
2,989 $283,925.11 2,989 $283,925.11
1,586 $118,442.48 1,586 $118,442.48
1,915 $28,725.00 1,915 $28,725.00
380 $5,700.00 380 $5,700.00
160 $2,400.00 160 $2,400.00
969 $18,411.00 969 $18,411.00
Totals: 7,999 $457,603.59 7,999 $457,603.59
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Printed By: jmm
Permit Total Fees:
Fee Amount
$2,998.55
$4.50
$1,199.42
$4,202.47
Print Date: 12/11/2008
Project Number: 08004689 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/11/2008 Page 3 of 4
Contractor: POUL CONSTRUCTION
Address: 18902 E 2ND
GREENACRES WA 99016
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
Contractor: POUL CONSTRUCTION
Address: 18902 E 2ND
GREENACRES WA 99016
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
Mechanical Permit
Firm: POUL CONSTRUCTION
Phone: (509) 979-5872
Units Unit Desc
2 NUMBER OF
2 NUMBER OF
2 # OF UNITS
2 NUMBER OF
8 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
Units
6
8
2
2
2
2
2
Operator: jmm Printed By: jmm
Permit Total Fees:
Plumbing Permit
Fee Amount
$20.00
$24.00
$2.00
$24.00
$80.00
$20.00
$20.00
$20.00
$20.00
$230.00
Firm: POUL CONSTRUCTION
Phone: (509) 979-5872
Unit Desc
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Print Date:
Fee Amount
$36.00
$48.00
$12.00
$12.00
$12.00
$12.00
$12.00
$144.00
12/11/2008
Project Number: 08004689
Notes:
Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 12/11/2008
Page 4 of 4
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$50.00
$4,202.47
$230.00
$144.00
Invoice Amount
$50.00
$4,202.47
$230.00
$144.00
$4,626.47 $4,626.47
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$4,202.47
$230.00
$144.00
$0.00
$4,626.47
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: jmm Printed By: jmm
Print Date: 12/11/2008
Permit Center _3 Br
• rimy®�r,� a �a 11703 E Sprague Ave, Suite B-3 ,� VALLEY
iu+ C .ANE
Spokane Valley, WA 99206 '. toWalley. (509)688-0036 FAX: (509)688-00370,[, 0 :
www.spokanevalley.org
Community Development
Residential Construction
Permit Application
PERMIT NUMBER:X_.4 V
PERMIT FEE:
C-onstru tc on ❑ Accessory Bldg
dition/Remodel ❑ Deck
ther:
SITE ADDRESS: ti W'7 L "'R ti q vt
ASSESSORS PARCEL NO: 4 S/ 64'. 03 3 61 LEGAL DESCRIPTION:
Building Owner: / -
Contractor: _.
Name: PA 2/"2n p ta-KO&•
/
Name: cc( tufr
pa o �S y i O (i
Address: t Z qo1 E 2 Ka
Address: LW q0Q a a i`Ol
City: C. / ,,, tt l il4ijgState: WA Zip: RQWt'L
pore( gt
City: SP O ft avr .( (< State: j%/ � Zip: 9 9 06.4
Phone:/S-oy) 474_s 2.72 Fats -0y On(„/7))1
1 // T t Fat
b T t
Phone: (�p/ r2.03s7/Fax:
7
GARAGE SQ. FTG:QQ
96�/ "" '
Contrac
or Lic No: Exp Date:
Contact Person .. ....
City Business Lic. No:
SEWER OR SEPTIC?
CM/ea
CONSTRUCTION TYPE:
ATS RCE:
q AZ
Name: -ea u (
p.
Phone: q 7 Q —s— 3 7 2
- - -.
: Describe the scope of work in detail:
Cost of Project: $ ') $O 1200
Proposed Use:
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
FTG:
zqt 1
2"" FLOOR SQ. FTG:
L2_4_6 75-n
UNFIN BASEMENT SQ. FTG:
/9i5
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG:QQ
96�/ "" '
DE 67. F S
/�oo/
30% SLOPES ON
PROPERTY.
# OF BEDROOMS: s•
SEWER OR SEPTIC?
CM/ea
CONSTRUCTION TYPE:
ATS RCE:
q AZ
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 ordi .nces. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be cessed.
SIGNATURE:
Method of Payment:
OF Cash
ankcard #:
Authorized Signature:
REVISED 2/15/07
❑ Check
❑ Mastercard
Expires:
DATE: ' a , O L(, ti ft
❑ VISA
VIN#:
Spokane •
Permit Center
11703 E Sprague Ave. Suite B-3
Spokane Valley, WA 99206
V2Llley (509)688-0036 FAX: (509)688-0037
www spokanevallev.org
Community Development
Mechanical Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ❑ Residential
SITE ADDRESS:
1( LSO 4 a Ma, h awe,
Building Owner
Name:
PM 4 ftf a Y2 A 75 7In ov
Phone: 5 7 9 C8 2 R Fax
Address:
e P 4,0 a &WK��'r.({Ni-/
City /.,,,, QLL State: yv/ A
Zip: Lt Q py
Contractor
=
1/�`_ -
Name: *
Q 6( I
l
..I�
e_,HgAtc4.'�" _.t^ O s
Co
Phone. ei 7 pre ? a Fax'
Address:
City: State.
Zip:
License No:
City Business Lic:
Contact
Y1 �YIy
u
Name
Phone: Phone:
DESCRIPTION OF WORK
# OF UNITS X COST
= TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
a
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 (W SEC 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 r.
501 - 1,000M BTU
X
525 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
20
13
RANGE
X
$10 00
14
DRYER
15
FUEL BURNING WATER HEATER
3
X
$10.00
02.0
X
$10 00
16
MISC FUEL BURNING APPLIANCE
X
$10 00
17
GAS PIPING (each outlet)
'd
x
51.00
18
DUCT SYSTEMS
19
VENTILATING FANS
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
ir
X
$10 00
X
$10 00
X
$12 00
Ao-g
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
2-
X
$10 00
2-0
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
26
AIR CONDITIONER
4-15 TON
X
$20.00
air
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 8 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:
CASH ElCHECK ❑ VISA 0
ARD #:
AUTHORIZED SIGNATURE:
REVISED t/26/05
EXPIRES
N
SUBTOTAL
tSO
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallcv.orc
Plumbing Permit Application ❑ Commercial
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
SITE ADDRESS: l I vO Q g /vt OI % A at ✓-"C--
Building Owner
Name:
"Avid
Phone: el 7 9 t,g Fax:
Address:
I p Cif0 f1
OO �f
n acl
O[
���
City: cyO�A/ v . State:
/� ,p
Zip:
11rLre/ %
I v'
Contractor
/
Name:
poom
r w�•- `
cow
r ac,t i. obi
"1
Phone- 1 7 q v- g '� 7'1 Fax:
OlState:
Address
City:
Zip:
License No.
City Business Lic
Contact
t,,
! a a ,
/
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS X COST
TOTAL AMOUNT " . •
1
TOILETS
WATER CLOSET, BIDETS
6
X $600
3C.
2
URINALS
X $600
3
TUBS
X $600
l2
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X $600
IQ
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,.
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT "
3
X $600
4;
6
DISHWASHER
X $600
a
7
CLOTHES WASHER
X $6.00
IQ
8
GARBAGE DISPOSAL
X $600
9
WATER SOFTENER
X $600
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
X $600
11
FLOOR DRAINS
AREA. CASE. COIL, TRENCH.
CONDENSATE
X $600
12
ROOF DRAINS/OVERFLOW DRAINS
X $600
13
FOUNTAINS. DRINKING
X $600
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 $600
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE.
AND R.P B.P D. FOR- VATS, TANKS,
BOILERS
X $600
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X $600
19
MEDICAL GAS (per outlet)
NITROUS. OXYGEN
X $600
20
MISCELLANEOUS PLUMBING FIXTURE
X $6 00
21
PRIVATE SEWAGE DISPOSAL/SYS
X $20 00
22
INDUSTRIAL WASTE INTERCEPTOR
X $1500
METHOD OF PAYMENT:
EYASH
Card#
❑ CHECK ❑ VISA ❑ MC
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES.
VIN.
SUBTOTAL
PROCESSING FEE
$35.00
1 TOTAL PERMIT FEE DUE:
}7q
Spokane
Valley
• For City Use Only
PLUS Project Number 8C. 4(0e9
Project Address ://3o9 G flt.-„
11703 E Sprague Ave Suite•B:3 •-Spokane Valley WA99206
509.688.0036 ♦ Fax: 509.688.00374 permttcenter@spokanevaltey.org
As part of our on=going commitment to customer service during _the. review "process of your project_
application, we are providing you with a TARGET DATE for the initial:technical`application`--review. If for,
• any reason.we cannot meet this date,'we will contact you with a revised target date...
Your application review TARGET DATE is 7/,
The TARGET DATE is the date we estimate your project application Will' have had its initial; technical'
review. it is not the date for approval or permit issuance. ,
Tips for a Smoother Project Application Review.
i Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on ntultinle applications; and it
may be several dans before they can look at •our new ar revised information. •
Designate a specific contact person to communicate with the City.
While the person designated as the applicant 's contact person with the City, can he changed, one individual. with the
expertise for dealing with reviewer continents would be the best choice for the entire review process.
Call staff regarding the status of your project only after the target date shown at the top of the page. •
Although you should be contacted on or by the target date, please feel free to contact ,us °evuu haven'1 heard from us
hr Vora' target date. Staff may contact you before the target date if tie initial review is' complete. By following this
procedure, you will save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This .means,' alt of: the' required
documents. as indicated on your Pre -Application Checklist have been submitted or have'- been approved' for deferred
submittal. This does not prevent technical staff from requesting additional information as•a result of their technical review.
2. Quality Check. The next step in the process is a quality check_to make sure that the application is reviewable and 'free.
from substantive Claws that would prevent technical staff from completing the technical review on it is started. When
this step is complete, your application will be, routed to the appropriate staff and remain in their review queue until it
comes up for review.
3. Technical Compliance. Once an application is administratively complete; it is routed to technical staff.for compliance
review. Depending 'on the type of project,' technical staff niay include multiple reviewers.'You should be•coritacted by
phone, fax, email, or mail by your TARGET DATE once the initial. technical compliance re iew is coinplete.
4. Permit Issuance. When the technical compliance review of the application is complete, including:any:subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center., When all sections
of the application are received, a Permit Specialist will process the.application and contact the person specified on your.
application for permit pick-up. Information regarding fees and pre -construction meetings'(if required)'silfbe provided by
the Permit Specialist at that time.
WHITE —APPLICANT PINK — BUILDING FILE
REV 9/07
Spokan��e
Valley°
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. sp o k a ne va l l e y. o re
Approach Permit Application
PERMIT NUMBER:
PERMIT FEE:
PROJECT ADDRESS I' FO I Palm
START DATE I Q. O B. V D
ANTICIPATED COMPLETION DATE
Building Owner:
Contractor:
Name:^/,n i ( et
Address: $ u " IX btOt
Name:
City: sr, g at4. V State: W 24
4 Zip: Q '!
Phone: q 7� 317 a Fax:
-Contact Person - 0 a q
Name:
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
frill compliance with the City of Spokane Valley Development Code. Referenced codes arc available for review at the City of Spokane
Valley Permit Center. 5) This City of Spokane \'alley Permit is not a permit or approval for any violation of federal, state or local laws,
codes or ordinances 6) Por additional information may be required to be submitted, and subsequently approved before this
application can be proc
Signature
ethod of Payment:
ash ❑ Check
B nkcard #: Expires: VIN#:
Datem, V 't 0
❑ Mastercard 0 VISA
Authorized Signature:
REVISED 39/06
Qo
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1154
GSF
11811
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