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2005, 11-29 Permit App: 05004465 ResidenceProject Number: 05004465 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/29/2005 Page 1 of 3 Project Information: .,a I VVTMZS :t .=moi Vt :nWY Contact: VIKING CONSTRUCTION INC Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -GAS Setbacks: Front 33 Left: 12 Right: 11 Rear: 23 Site Information: Plat Key: MigliENSEEZrw WSIMWMINSIL Name: Hidden Valley Address: 2605 W HAYDEN C - S - Z: HAYDEN LAKE, ID 83835 Phone: (208) 762-9106 Group Name: Project Name: District: East Parcel Number: 55073.1916 Block: 1 SiteAddress: 17408 E MANSFIELD AVE Location:: CSV Zoning: UR -3.5 Water District: Area: 7,006 Sq Ft Nbr of Bldgs: 1 Review Information: Urban Residential 3.5 Lot: 16 Owner: Name: VIKING CONSTRUCTION INC Address: 2605 W HAYDEN HAYDEN LAKE, ID 83835 Hold: ❑ Width: 70 Depth: 100 Right Of Way (ft): 38 Nbr of Dwellings: 1 Review Site Plan Review d By: Plan Review Originally Released: 11/23/2005 By: cjjanssen eased y Approach / Drainage Originally Released: 11/29/2005 By: TMELBOU `Released By: Sewer Review Permits: Originally Released: 11/23/2005 By: cjjans Released Operator: CJJ Printed By: CJJ Print Date: 11/29/2005 Project Number: 05004465 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/29/2005 Page 2 of 3 Contractor: VIKING CONSTRUCTION Address: 2605 W HAYDEN AVE HAYDEN, ID 83835 Item Description APPROACH INSPECTION CONST IN ROW - APPROACH Contractor: VIKING CONSTRUCTION Address: 2605 W HAYDEN AVE HAYDEN, ID 83835 Description BASEMENT U DECK GARAGE RESIDENCE Grp Type Notes R-3 VB R-3 VB U-1 VB R-3 VB Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW Contractor: AIR DESIGN INC Address: 1807 E FRANCIS AVE SPOKANE, WA 99207 Item Description GAS WATER HEATER GAS APPLIANCE<=100,000BTU GAS PIPING HEAT PUMP OR A/C 0-3 TONS VENTILATING FANS Units 1 1 Approach Firm: VIKING CONSTRUCTION Phone: (208) 762-9106 Unit Desc NUMBER OF NUMBER OF Permit Total Fees: Building Permit Fee Amount $25.00 $25.00 $50.00 Firm: VIKING CONSTRUCTION Phone: (208) 762-9106 This Application: Total Project: Sq Ft Valuation Sq Ft Valuation 906 $13,590.00 906 $13,590.00 124 $1,860.00 124 $1,860.00 360 $6,840.00 360 $6,840.00 949 $70,871.32 949 $70,871.32 Totals: 2,339 $93,161.32 2,339 $93,161.32 Units Unit Desc 1 SELECT 1 SELECT 1 SELECT Permit Total Fees: Mechanical Permit Fee Amount $951.75 $4.50 $380.70 $1,336.95 Firm: AIR DESIGN INC Phone: (509) 487-4328 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 2 # OF UNITS 1 NUMBER OF 3 NUMBER OF Operator: CJJ Printed By: CJJ Permit Total Fees: Fee Amount $10.00 $12.00 $2.00 $12.00 $30.00 $66.00 Print Date: 11/29/2005 Project Number: 05004465 Notes Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/29/2005 Page 3 of 3 Payment Summary Permit Type Approach Building Permit Mechanical Permit Fee Amount $50.00 $1,336.95 $66.00 Invoice Amount $50.00 $1,336.95 $66.00 $1,452.95 $1,452.95 Amount Paid $0.00 $0.00 $0.00 Amount Owing $50.00 $1,336.95 $66.00 $0.00 $1,452.95 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: CJJ Printed By: CJJ Print Date: 11/29/2005 Sakar�e —.OVAley Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Vallev_ . WA 99206 , (509)688 003 (509)688-00-7-) �>�uoo-vwG FAX: \ v.spokanevallev.ore.com 1[31 l i� �) t ID) �) L Residential Construction Permit Application [:(New Construction ❑ Addition/Remodel o Other: o Accessory Bldg o Deck SITE ADDRESS n LA V?; ASSESSORS PARCEL NO: 6..1i ;���jC—I�� U1 t LEGAL DESCRIPTION: LC k" kLL Building owner Name: Si /Y L_ Address: City: Zip: Name: V d +.-0k\ (` om-3-'Y uL� (cc) TN L Address: p l ` �.>( tl \ � 1�)_Ui\.i City: ..V. ; ( j\ GARAGE SQ. Q.SQ. FTG: 6 CL Zip: 3 e :3 Phone: 1 ll,.). 511 Ur..)- Fax: i (ig) - U. Ll Contact Person Name: Phone: Describe the scope of work in detail: Contractor Name: Si /Y L_ Address: City: Zip: Phone: Fax: Lic No: N \\LA 1\..i1._Kt b )Exp. Date: City Business Lic No: Cost of Project: **************The following MUST be complete: (write N/A if not applicable)********************** HEIGHT TO�PQAtK: DIMEf�S�IO�NS� � �, ��� # OF STORIES: ` TOT1L�HABI�� E SPACE: MAIN FLOOR TO SQ. FTG: l a l< 2Nu FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: ,L l c, �O 0,4_ IMPERVIOUS SURFACE AREA: Is FINISHED BASEM IT SQ. FTG: i GARAGE SQ. Q.SQ. FTG: 6 CL DECK/COV. PATIO SQ. FTG: % 30% SLOPES ON PROPERTY: IC'/4 # OF BEDRO S: CONSTRUCTION TYPE: HEAT SOURCE: SEWER OR SEPTIC? 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 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. 4 • Signature C L1 Date Method of Payment: (Faxed permit applicaJons will only be accepted with major bankcard) ❑ Cash El Check ❑ Mastercard ❑ VISA Bankcard #: Expires: VIN#: ❑ Other Authorized Signature: REVISED 8/25/2005 Call 24 ho Z1 C I.LIS1ea011 reqUired Zrhn-.nr.) znn L C,A, .6(30.-Uld] I DEPARTMENT OF PUBLIC Vit.fORKS Arrtrctpatacf start data Permit # Firt% APPROACH PFT P LICA Locadon of property qpb ce.ddres?/Parcel #, favailabie) Ar I1jjil.f,)(1!?;1:11LA1/4'1"1-11Qtle -1.21r,f4, • Contractor's Hanle•s: Address ,L)-1 Ufa. olo_til Phone Contractor's Reg# Y‘ C -rt-?) PROJECT DESCRIPTION (Provide site sizetoh) LJ Residential.Driveway Ei CornmerciallOndcAstrid Driveviray ri Existing Curb & Gutter El Rural Road Section Sidewalk Repair/Construction 1 1 Culvert linstaliation Fr] Other conditions ITYV ;I See construction requirements and details on reverse. Bond/insurance certification must be on file with the City. SETZLIFIcvm,0i4E)11-10NS: PERMIT FEE $ Ens section Fee$ I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit Gard. Card 4-= =---iraf-ion Date IWarne of Holder Pald$ Sianature Date init ** TOTAL PAGE.05 ** CD N i v UTILITIES DIVISION A DrvrsloN OF THE PUBLIC WORKS DEPARTMENT `I. Bruce Rawls, P.E., Utilities Director GENERAL FACILITIES CHARGE (GFC) Pv t` ren '1Ok SrLECV1% ro RECORD PLEASE NOTE: Forrin must be filled out accurately and in its entirety, and signed, or a paring will not be issued Cate: 1k � <� I L5 Plat Name: 07 `l Lot No(s): Site Address(es): \-1 Lko.eG Owner Narne: V L ruJc\ PRiNT Owner's Name PRINT Builder's Name OR Builder Name: Block No(s): Parcel No(s): :5,5 b„13 0 I T S Payment Option Selected (Check One): 1. ❑ GFC payment received at issuance of Sewer Connection Permit by Division of Utilities 2. [GFC to be paid at closing. See Special Conditions below regarding GFC rate. 3. ❑ GFC payment in 24 equal monthly payments upon establishment of Sewer Billing Account. See Special Conditions below regarding GFC rate. If Option No. 3 is selected, complete one of the following statements: a. Owner's Statement: I, , understand that I will be billed for the applicable GFC amount in 24 monthly installments. The monthly GFC installments will be added to my monthly sewer service charges. b. Builder's Statement: I, , understand that because I am selecting this option for payment of the GFC, the purchaser of the home will be responsible for payment of the applicable GFC in 24 equal monthly installments. I agree to formally disclose to potential buyers of the property that the GFC charges will be added to the monthly sewer service billings as soon as billing commences. Special Conditions: Sewer connection permits are valid for 12 months from date of issue. If final connection is not completed and inspected within :he 12 -month life of the permit, a new permit will be required and the GFC rate that is in effect when the new permit is issued will apply. Other Special Conditions: ❑ No EJ yes - See Reverse Side of Form Owner's or 1.1D I.by Elder's Signature Date Located at: 1.026 W. Broadway, 4th Floorp Spokane County, Division of Uii61i� 6 W. Broadway 6 Spokane, WA $9260ay04 0 Option Form, Revised 02-04-04 (509) 477-3604 6 FAX: (509) 477-4715 = TDD: (509) 47/-7133 ` o :aIle County L'iiisIcn .o.r L-UIIe_ --_t� C0'..\7_\ F_CT L] \ _ _ s.''_1. .`__' L Il.,_=: -.'J �. . ,... -- ,c_non Fr/t-7! _,,.. �. -lin_ 2'27 _`__.... _..— ... _ — _ -' : _ "_L.. ,. ... .10, .. .-..tsr,. _._ ... _. - c see 'eon.. ._. _�. PROJECT INF O R11/iL_T1 C.'s:1\ s in \tidlres.; I1LI(J U h r\Sec;, .(A Imo, k.•!A-\k t rarest Numbs: t✓ lo . ;slid;: 1lroicct Nnmc: 00 4- T1 0---- U1.11) 1Jame: P.PPLICMJLG BOXES Re): 1: Qh111:Il ❑ Dry Sewer ❑ Repair [1 A ddition Q Abantlonmcnt LY 1(t:::ltic:nlial Er—New 0 Commercial 0 Ncw Ci '1'cmporary r\titiress namc N Lx\--)\-y,a ,n kk)• "^v' t� . •rlp: U��_�iS � Phone: �ly � � t.. FIRST TIME CONTRACTORS OR. HOME OWNERS PERFORATING THE INSTALLATION MUST FIRST CONTACT TI -IE UTILITIES DIVISION BEFORE PERMIT(S) CAN BE ISSUED. SIGNATURE OF U'1'ILITIES DIVISION PERSON COI\I'I'ACJ'IiD: Cont actor (company mime): Sate contractor license number: ► iak;) Business address: F • K\ City/State: 1..\i1i k 0 i1': lip: tl t Contact Name: Phone Number: .11D) INTERIOR PLUMBING ALTERATIONS? (yes/no) circle one Fill out the infwniation in the table below if applicable" Contractor (if different from above): Phone: liminess Address: City/State/Gip "For plumbing revera fir information, sec reverse sitar of this form. FEE INFORMATION Number of Buildings connecting to sewer X (times) $100 (per bldg) _ $ -i- $10.00 = I0CI1'1' 01, WAN' 1'Iat,,1T Por a single-family residential unit, one permit is required; Por a condominium, townhouse, duplex, triplex or humph x with sept rate ownership (as determined by Int lines) separate address and .separate :dub, nue permit is required per address per stub; For a single building duplex, triplex or fuurplex with single ownership, one permit is required Mluhiple building;; (apartments, industrial complexes) with single ownership, one permit required per building eonncnin Io the sesvrr. (FOR SITUATIONS NOT COVERED HERE, CALL THE COUNTY DIVISION OF UTILITIES AT 477-3604) 1s any of the work to be performed in or from the count, right-of-way? O Yes 0 No APPl.1CAN1'SIGN:\7'LIRI7:1 ( <<1. IMethod of Payment: ❑ Cash ❑ Check Date: 0 Visa ❑ -MasterCard 0 Discover Card Expires: Bankcard Number: Authorized Signature: ::70.... _ Col:nn' J:•..51O' of oulith:n ,.; Low I".nr;Jr__:-._. c '.C26 tst Bmeuw,c-ntnut'Spokent'tii 99260 n7- :,.7, t:55' 477 7150 r. ^7,i". 'r.... r,ncr, .:77 -71 Spokane .Val ley Community Development Mechanical Permit Application o Commercial Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.orct.com SITE ADDRESS 1 L(A L 1\ (.•. PERMIT NUMBER: PERMIT FEE: 4 Residential Building owner Name: X \V re C1 1 ). (A 1 r) - 0.r, Phone: 5 )-11n-4 f , Fax 419---) - 51.71 t Address: U.') . tkv QV NIA `t-, _ City vitw vs(,, n State 1 f Zip 9I )?6 Contractor Name: Nit- N.--. In n Phone: Fax: Address: City State Zip License No: City Business License No: Contact Name: Phone: 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 1 X $10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING (each outlet) X $1.00 = 18 DUCT SYSTEMS X $10.00 = 19 VENTILATING FANS 5 X $10.00 = 20 AIR HANDLER (DOES NOT include ducting) Equal to or Tess than 10,000 CFM X $12.00 = 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 1 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: ❑CASH 0 CHECK 0 VISA ❑ MC CARD #: SUBTOTAL DATE: PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05 12/05/2005 12: 20 20E7E24507 V1K1NU LUN51 H 4 L V 1 1 v 1 --- COUNTY U N .E , rlr Sro� ,IV ENT OF BUILDING PLA- 0 DErn12� 1 1 W/09:2,60-005' .1026 WEST BROADWAY AVENUE• SPOKANE, CAUNT! 12 0 Spol;n n r2 os Inv: 1 issue Date: Site Informatjon VALLEY 05009164 Project Lumber: HiDDE� Permit Use: NEW SEWER CONNECT, Site address: 17408 E MANSFIELD AVE Parcel Number: 55073.1916 Subdivision: RANGE Block: Lot: Zoning: UNK Unknown Owner: VIKING CONSTRUCTION 1NC Address: 2605 W HAYDEN HAYDEN LAKE, ID 63635 Building inspector: JOHN LARSOi`1 Water Dist: Applicant: VIKING CONSTRUCTION INC 2605 W HAYDEN }IAYDEN LAKE, ID 33835 Contact: VIKING CONSTRUCTION INC 2605 \V HAYDEN HAYDEN LAKE, ID 83E35 Left: Right: Setbacks -Front: Group Namc: Project Name: Setuer Colliteerinti Permir Contractor: OWNER SI:WF.R CONNECTION Phone: (208) 762-9106 Phone: (208)762-9106 Rear: License Ov:NF.R SS5.00 PR:1CF.SSING FEE Total Permit Fee: 1 515.00 5100.00 FOR SEWER 1NSFECTTONS CALL (509) 477-3604 UTILITIES E:10 -5.0C PM MONDAY TI.1RU FRIDAY Call for inspection prior to cover ONE WORKING DAY NOTICE REQUIRED. Contractor or applicant is to Feld locate and confirm ensure thathc on and they have position acceptsele;grade and are clear a er stub pn or to any d unobstruetted to the main Sewer stubs are to be checked prior ,o connection sewer. Sewer lines should be constructed to allow for gravity flow from the lowest level of the structures Yater lines, etc. This permit must be presented to the job site inspector for verification. To locate buried cables, Sas piping, CALL BEFORE YOU DIG, (509)456-S000. BE STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE "CALL BEFORE YOU DIG' CENTER NOTIFIED, CALL BEFORE YOU DIG AT LEAST 2 WORKING DAYS IN ADVANCE, (509)456.8000. Spokane County Code requires the installer comply with all requirements of the Was`ington Slate Dept of Labor and Industries, including those related to trench safety. Payment Summary Total Fees AmountPaltl AmountOwiny. 5100.00 8100.00 70.00 Processed By: Hansen, Tom Printed By: W','E,NDEI_, GLORIA DEC 05 2025 11:47 Tran Date 12/1/2005 Page I of 1 Receipt # Payment A mt 7472 5100.00 PERMIT 2087E245©7 PAGE.01