2004, 09-09 Permit App: BLD-04-07605 Egress Windows*lane
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•
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