2003, 06-24 Permit App: BD03-692 ResidenceRPR 29 2003 1647 FR
City of
SPOKANE VALLEY
Box 1 OWNER
_ $! (Ill...tl Ca
OWNER'S ADORES
DESCRIBE JOB
TO 12087624507 P.01'05
CoW
PERMIT# anal -192
BUILDING PERMIT APPLICATION
JOB LOCATION iu30- F *011e.
CITY HONE act=1(-q iota
ctan
THIS PROPERTY IS OW) ED BY: SINGL RIED
PARTNERSHIP CORP._
BOX 2 CONTRACTOR'S NAME Y I J n'] r on41f(t c+ln��� �� P PHONE ;%‘ 1(p3 -(I (ao
CONTRACTOR'S ADDRESS
` XACM w c . (kit ' o Y7 YIUf' CITY t-' 1 (:.q (1
V
CONTRACTOR'S REG.# ( � I h C i C(_I¢a;tic EXPIRATION DATE 31 (1 (e-1
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED) ``''
BOX 3 CONTACT PERSON OF PROJECT \( WW2 CIC.I' On-Th PHONE no9i_,(oa- 1 rD(o
ADDRESS 4iPlYZ: ('a✓. ktft,1(1,.p,R CILK CITY ZIP fSt 33
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ p EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER 9 51 Q 3 :3(a
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WfTH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR " qq / 2ND FLOOR /
3RD FLOOR / _ OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED 9010/_ DECK / GARAGE 31-c, /_
CARPORT _/— TOTAL / HEIGHT TO PEAK OF BUILDING FT.
BOX 8 ?C SINGLE FAMILY` - )NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) O EXISTING STRUCTURE
( ) COMMERCIAL / INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins) man MECHANICAL APPLIANCES .
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL
BOX 10 Water Service meter size (if known) Also see BOX 4
BOX 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a " Street Use Permit' for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND '
CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISESTOPERFORM THE WORT KI FO WHI H THE APPLICATION I MAD ^
OWNER/AGENT �i-- 1,1'LQ_,I'a_ DATE (49' ee- /T (OVER)
METHOD 0
❑ CASH
DATE:
RPR 29 2003 16:48 FR
Sjpoakanee
Plumbing Permit Application
TO 12087624507
P.03/05
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane, Valley, WA 99206 509.683-0037 - Fax
' For Inspections, call 509-688-0054
PROJECT
v
PERAUT
USE S_
DETAILS
`f(,Q 1 w
PHONE(LmeConac)y'l
I0seADDRES(IA
MAILING ADDRESS:
a -POS Oa Pit., keg0 n P - lgi t Os n LT. S3S 35
AMOUNT
(street) (city/state) (ZIP)
TOILETS
CONTRACTOR:LICENSE
Ile ra�n "Pl,.tmhu-r`
t:
RELKmP1 - 0--/i b�
X
MAILING ADDRESS:
2>i -Al 14 5 R vernAn
PHONE 5: /� a ( — i )��"l t 3
1
I 12-
1., ujn Ab37
IIRINALS
(street) (city/state) (2IP)
PLUMBING FIXTURES
BANKCARD NUMBER
AUD'IORIZED SIGNATURE.
DESCRIPTION
DETAILS
1 O UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATFRCLosEr, BIDETS
of
X
56
-
I 12-
2
2
IIRINALS
X
$6
-
3
TUBS
o`a
X
56
-
/ 0--
4
4
SHOWERS (PER TRAP)
RATH, STALL, ONSITE BUILT
X
56
-
S
SINES
LAVS/BASINS, BAR. FLOOR IOTC'IIE N,
LAUNDRY, UTILITY, JANITOR PHOTO, X-
RAY, PDOD, PREP/CUUNARY/MEAT
X
56
-
, 0
6
PLSHWASMER
1
X
56
-
6
7
CLOTHES WASHER
1
X
56
-
as
5
GARBAGE DISPOSAL
1
X
56
-
4
9
WATER SOFTENER
X
S6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56
-
11
FLOOR DRAINS
AREA, CASE, COIL TRENCH, CONDENSATE
X
56
•
12
FOUNTAINS, DRINKING
X
56
-
13
WATER F1FING/DRAIN•TN
WASTE, VLNT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56
•
14
SEWAGE EJECTOR
GRANDER SUMP PUMP
X
56
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE BB,
STEAMER, PROOFER CARBONATOR^
SWAMP COOLER
d
X
$6
-
/ �1
'fes
16
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK VALVE, AND
RPR.P.D. FOR VATS, TANKS, BOILERS
X .
16
-
17
SPRINKLER SYSTEM
X
525
•
15
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
56
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
•
20
MISC. PLUMBING FDCTURE
X
56
-
PAYMENT'
CHECK
r )
_ _ .. s
SUBTOTAL:
;72_
PLUS PROCESSING FEE:
:a
S3bt>'
I
■ ■
TOTAL PERMIT FEE DUE
BANKCARD NUMBER
AUD'IORIZED SIGNATURE.
RPR 29 2003 16:48 FR
Sikaane
essznalkY
Mechanical Permit Application
TO 12087624507
P.02/05
11707 East Sprague Avenue, Suite 106 509.688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
CT
ADD : 143Da E f
PERMIT
USE SI -1C
M
OWNER: v 1 \j1 ,M, l it: illi 1 11 (
"�1 J
1l
PHONE (Daytime Contact): './Li -I (0
MAILING ADDRESS:
tj +j
rUnc W laIA/ko{1 11•9 l -Lc .
-Th P) 35
(street) ` (Caty/state)-
(ZIP)
CONTRACTOR: tl1�n_ 'll rIX Q
-1^ ' �7..iPHONE
�1
LtiabaF)w-,-
MAILING ADDRESS:
1LICENSE1:
3: <�o9 �d�
) ^ a —cscoCi "Ci
6t - Ni Cruo.rn tnna r41- l
1 ] -1 S,3R81 C
(street) (city/state)
1 (ZIP)
METHOD OP PA
❑ CASH 0
DATE: EXPIRES:
BANKCARD NUMBER:
AUTNOR)ZF.D SIGNATURE:
<I
DESCRIPTION OF WORK
OOP UNJTS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
•OR<100400
1
X
515
-
f;
2
FUEL BURNING APPUANCE
> 100400
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
• OR 4 cepa
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 40,000
X
SIO
-
5
USED APPLIANCE (WSEC min AFUE r6Eng)
• of c 400,000
X
SSO
•
6
USED APPLIANCE (WSEC men. APUE Mting)
> 400,000
X
510
•
7
BORER/REFRICERATION
1.1OM ETU
X
515
•
8
BOILFR/REPRICERATION
101 • RCM BTU
X
538
•
9
801LER/RBFRICERATION
501 • LOOM BTU
X
S39
-
10
BORER/REFRIGERATION
1001- L7SM BTU
X
S57
-
11
BOILER/REFRIGERATION
•1750M BTU
X
595
-
12
GAS IAC, GAS INSERT, CAS FIREPLACE
-
X
510
•
L3
RANGE
-
X
510 -
-
I4
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
-
1
X
510
/0
16
RISC FUEL BURNING APDL
-
X
510
•
17
GAS PRING * Outlet)
-
4
X
51
-
K
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
X
510
•
B, 0
20
AR HANDLER (DOES NOT fodud>ducang)
• OR < 10,000CFM
X
512
•
21
AIR HANDLER (DOES NOT Include ducting)
> 1040 CFM
X
S19
•
U
EVAPORATIVE COOLERS
-
X
SIO
-
73
TYPE IHOOD
-
X
550
•
24
TYPB a HOOD
-
1
X
510
•
1 O
25
HEAT PU,LIP/ARCONDPDONER
0.3 TON
X
ra
26
AIR CONDITIONER
3-15 TON
X
S20
•
V
AIRCONDmONER
1530 TON
X
525
-
28
AIR CONDITIONER
30.50 TON
X
533
-
29
AIRCONDf71ONER
•50 TON
X
560
•
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
x
510
•
32
WOOD STOVE• FREE STANDING
-
X
525
-
KENT
—` •.
smarm.:
r7et,
PLUS PROCESSING FEE
$9BEMS $,pp�
TOTAL PERMIT FEE DUE
DATE: EXPIRES:
BANKCARD NUMBER:
AUTNOR)ZF.D SIGNATURE:
<I