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2004, 09-09 Permit App: BLD-04-07605 Egress Windows*lane 0004\a„ i01;e3' • 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: ' VtiCLA-A 1c► rPNj Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: S �(' I. till C %4( Buildin Permit g El in Use ❑Gradin ❑ Relocation 9 ❑Manufactured Home ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION Owner. Mt` Ak— I� � tvarti. (r S S-� ❑ Phone: 92(1-3k310 ax: q22 cr7 4A Address: l4418-,). //dottya t4 ? c)poiela tntt t,JA 9 2_olty City • State Zip Code 0 Contractor: -,,(4 ((s -Nn c • ❑ Phone: 727-T 26 Fax: Address: o .3 o (-Hwezr r av i,-/ ?fel/ City State Zip Code Applicant: "&n aL eywhonr Phone: Fax: Address: City • Architect: State Zip Code Phone: Fax: Address: City State Zip Code WA State Contractor License#: Tet (!CSI (74 -4? -6-- Contact: - PERMIT/BUILDING INFORMATION HEIGHT TO PEAK DIMENSIONS: # OF STORIES: MAIN FLOOR TO SQ. FTG: Du FLOOR SQ: FTG: - -UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ: FTG: DECKICOV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: ' 30% SLOPES ON PROPERTY: - SEWER OR ON-SITE SEPTIC SYSTEM? 1 MANUFACTURED HOME Width.; Manufacturer: • Length: Year: Pit Set . • RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: . DateTme: Tent: Fireworks Di§play: Blasting: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address. Phone: Fax: City Inspector: Phone: Address: State Zip Fax: City State . Zip SPECIAL INSPECTIONS ❑ BOLTING ❑ CONCRETE 0 REINFORCEMENT Firm Name: Phone:. I nspector(s): Fax: 0 -WELDING DISCLAIMER 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 ofSpokane Valley Permit is not a permit or approval for any violation of federal, state or lobal laws, codes or ordinances. Ownership of resulting development rights granted by any issued pe re to the propertyo ner. Yien164. �1 ra SSP / Signature(/� Y/ Oiv /ell Print Name Method of Payment: (Faxed permit applications will only be accepted with major bankcard)_ ❑ Cash ❑ Check 0 Mastercard . 0 VISA Bankcard #: Authorized Signature: Expires: VIN#: 0 Other Sep 07 2004 4:34PM BOYD, BROWN S. CO' 5093402690 p.1 Facsimile BOYD, BROWN 8 CO., INC. 316 W Boone AVE Suite 363 www.spokaneinsurance.net SPOKANE WA 99201 Phone 340-BOYD(2693) bboyd@spokanelnsuranoe.net Fax (509)340-2690 September 7, 2004 Total Number of Pages: 1 Insured: Company: Policy#: Policy Period: Phone: Fax: 922-8746 Brenda • Re: American States Insurance Company Pol# 010E8805675 Dear Brenda: Please see certificate of Insurance for Trecon... Sincerely T-720 tic,. HO_r(�-._+t.�&t) Beth Harpster, BETH@SPOKANEINSURANCE.NET CSR bah Page 1 TRECON, INC. American States Insurance Company 010E6805675 DEC 5 03 To: DEC 5 04 09/06/2004 18:54 5098925939 TRECON, INC. TRECON CONCRETE CUTTING CORE DRILLING INDUSTRIAL CAULKING FIRE STOPPING PO BOX 180-.GREENACRES, WA 99016 PHONE (509) 927-2326 / FAX (509) 892-3939 ATRECOIO44RE PAGE 01/01 September 7, 2004 Clint & Brenda Grasse) Fax (509)922-8748 Re: Egress windows at 12806 E Main Per your request, Trecon would like to submit a quote for the completion of three egress windows at 12808 E Main in the Spokane Valley. The windows are on the west and north side of the house. Pricing includes the following: • Digging • Cutting • Concrete removal • Window placemen o • Finish windows with MDF (unpainted) , �1�iW;l-- nc�j p w-14 cacktt ch' • ndow wells * ( -S • Windows • Trim (MDF) Total cost for all windows is $2250.00 + tax and permits. Please call 11 you should have any questions. The expected date for completion of this work is by Friday September 10111. Please note our contractor registration number at the top of this proposal and an insurance certificate will be sent to you via fax today. Sincerely, Scott Conant President Sep 07 2004 4:34PM BOYD, BROWN 6 CO 5093402690 p.2 ACORD INSURANCE DATE(MvVOD/YVW) BEP 7 OI TM CERTIFICATE OF LIABILITY PRODUCER BOND, BROWN 8 CO., INC- 916 W BOONE AVE SURE 363 WWW.SPONANEINSU SUITE SPOKANE WA 09201 TNIS CERTIFICATE IS ISSUED AS A MATTER OF ONLY AND CONFERS NO RIGHTS UPON TEE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, ALTER THE COVERAGE AFFORDED BY THE POLICES INFORMATION EXTEND OR BELOW. INSURERS AFFORDING COVERAGE MAN: # INSURED TRECON, INC. C/O SCOTT CONANT & JOHN TREJBAL P O BOX 180 GREEN ACRES WA 99018 ral INSURER A: American Stales Insurance Company LIABUTY INSURERS' DEC 6 03 WSURER C: EACH OCCURRENCE INSURER 19 INSURER E: X THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POL CY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFCATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLCIES DESCRIBED HEREIN IS SUBJECT TD ALL THE TERMS, EXCLUSIONS AND COEDITORS OF SUCH POLICIESS-AGGREGATE UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CAIMS. EMR ADDL WMI{c TYPE DF INSURANCE POLICY NUMBER PODCT EFFM:IM PAT, NMMDDIYV) PDLKY EXPIRATIONLTA RATE IMM'DOWYI LMITS GENERAL LIABUTY 010E8805675 DEC 6 03 DEC 504 EACH OCCURRENCE 1 1,000,000 X COMMERCIAL GENERAL UABILITY DAMAGE TO RENTED f 200,000 CLAVES MADEu OCCUR P, AP MED. ! *XP (My one wlTan7 f 10r000 A PERSONALS ADV INJURY 1 1,000,000 GENERAL AGGREGATE f 2,000,000 GEN. AGGREGATE LIMIT APPLIESPER ( PROOUCTSCONNOP AGO. f 2,005,000 -1 POLICY 17 PRWECT 110C AUTOMOBILE X LIABILITY ANY AUTO 010E8805875 DEC 8 03 DEC 504 COMBINED SmGLE LIMIT a M:DOAAIT f 1,000,000 A ALL OWNEDAIROS SCHEDULED AUTOS • BODILY INJURY (Ps/person) 1 X X HIRED AUTOS NON -OWNED Autos BODILY INJURY BO I moan) f - PROPERTY DAMAGE (PEI P¢Ma1) $ GARAGE LIABILITY —1 AUTO ONLV - EA ACCIDENT 1 ANY AUTO OTTER THAN EA ACC 3 AUTD ONLY wCA 5 EXCESS/ UMaRELLA LIABILITY 015U28142550 DEC 503 DEC 504 EACH OCCURRENCE 1 2,000,000 X OCCUR [J CLAMSMADE AGGREGATE 5 2,000,000 1 _ DEDUCTIBLE f X RETENTION f 10,000 1 WORKFRICOMPPNSATION AND LIABLRY 010E8805S75 DEC 503 DEC 504 WC Mill- i ll- On/EREEIPLOYERS Mew rmv,Iwn A NWNIDPRIrORPAAT,aw.AGVINE EL EACH ACCIDENT S 1,000,000 OPrILDOMEIIEl, eiaMDmf ern. gems.. moor EL. OfSEASE-EA EMPLOYEE f 1,000,000 WKIAL PROVISIONS Mow EL DISEASE-POLICYLIMIT 1 • 2,000,000, OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEH)CLESIEXCLUSIONS ADDED 8Y ENDORSEMENT/ SPECIAL PROVISIONS Attention: Attention:1 SHOULD AM' OF 111E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATON DATE THEREOF. 711E ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. A EDREPRESENTATIVE 1� ^-`` �'A J L.J I "1 v\ \ D 25 (2001/08) Certificate # 2331 '® ACORD CORPORATION 1888 • REVIEWED FOR CODE COMPLIANCE SP VALLEY 3UILDING DIVISION 09/4 ck -hcre THIS BUILDING SUBJECT TO FIELD INSPECTION CORRECTIONS CITY COPY