2008, 12-16 Permit: 08004798 Adult Family Homefer
Spokane
Valley®
BUILDING DIVISION
11703 E. Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Site Information
Project Information
Site Address: 12022 E MAXWELL AVE
Parcel Number: 45161.0141
Subdivision:
Block:
Lot:
Zoning: R-2 SF Res Suburban District
Owner: LOWELL, JAMES A
Address: 12022 E MAXWELL AVE
SPOKANE VALLEY, WA 99206
Building Inspector: NORTH
Water Dist: MODERN
Project Number: 08004798 Inv: 1 Issue Date: 12/16/2008
Permit Use: ADULT FAMILY HOME
Applicant: LOWELL, JAMES A
12022 E MAXWELL AVE
SPOKANE VALLEY, WA 99206 Phone: (509) 924-9443
Contact: LOWELL, JAMES A
12022 E MAXWELL AVE
SPOKANE VALLEY, WA 99206 Phone: (509) 924-9443
Setbacks - Front: Left: Right: Rear:
Group Name:
Project Name:
Permits
Building Permit
Contractor: OWNER
License #: OWNER
HOURLY REVIEW FEE
FOR BUILDING INSPECTIONS CALL (509) 688-0054.
1 $58.00
Total Permit Fee: $58.00
Payment Summary
Total Fees AmountPaid AmountOwing
$58.00 $58.00 $0.00
Processed By: DAVIS, JENNA
Printed By: PATRICIA PRINCE
Tran Date Receipt # Payment Amt
12/16/2008
Page 1 of 1
16805 558.00
PERMIT
NOTICE
The ownership of a Spokane Valley Development Permit will inure to the property owner. The permit applicant, by
definition, is the property owner or an authorized agent of the property owner. It is the responsibility of the
applicant/permittee that the use described on the front of this permit complies with applicable codes and that required
inspections are requested. Failure to request inspections as listed below and obtain the necessary approvals before
progressing beyond the point where inspections are required may necessitate removal of certain parts of the
construction at the applicant's/permittee's or property owner's expense. At a minimum, the following inspections ARE
REQUIRED by City Code:
FOOTING - when forms and reinforcement are in place and prior to placement of concrete -all structures, including manufactured homes.
NOTE: This inspection includes review of the structure's setback from property lines. Minimum setbacks are established by City of Spokane
Valley Ordinance. Curb lines and fence lines are not necessarily indicative of property lines. The responsibility to comply with applicable
setback provisions lies solely with the permittee -neither the City of Spokane Valley nor Its authorized representatives assume any
responsibility for the verification or location of your property lines. Please verify their location prior to locating your structure. Failure to
properly locate the structure may require its relocation at the owner's/permittee's expense.
FOUNDATION - when forms and reinforcement are in place and prior to placement of concrete.
PLUMBING - after rough -in, before covering, and final.
MECHANICAL - rough -in of piping, before covering, metal chimneys before concealment, and final.
FRAMING - after all framing, bracing and blocking is in place, rough electrical, plumbing and mechanical systems are complete, and prior to
concealing.
FINAL - when complete and prior to occupancy and/or use. All permits require final inspection.
NOTE: In addition to Inspection of the structure. this inspection includes review of site improvements (typically depicted on the approved site
plan) required by ordinance or as a condition of approval of this permit. Items such as the installation of fire hydrants. fire department access,
on-site drainage ('208' swales), road improvements, parking and landscaping are common requirements of a permit/site plan which must be
completed prior to final approval of a building or issuance of a Certificate of Occupancy.
MANUFACTURED HOMES - Final inspection required when complete, stairs, handrails, skirting, etc. installed, and prior to occupancy:
completed inspection record card must be available on site.
PLUMBING REVERSALS FOR SEWER CONNECTIONS - prior to cover.
RIGHT-OF-WAY/APPROACH - prior to placement of concrete/asphalt or, if gravel approach, after completion.
In addition to the above, any plumbing or mechanical systems or matenal which would be concealed by framing, drywall, concrete, etc. must
be inspected prior to cover. Check with the Building department for `special inspections" in conjunction with commercial projects.
FOR INSPECTIONS
Please give one working day/24 hour notice. Different parts of your project may require permits and inspections from more than one agency.
Building, plumbing (includes interior reversals for sewer) and
mechanical, City of Spokane Valley Building Division 688-0054
Road cuts for utilities or driveways, City of Spokane Valley
Public Works 688-0195 or State Dept of Transportation
324-6000
Permits and inspections for eiecincal Along. Stale Department of Labor Permits and inspections roc Sewer Connection. Spokane County Utilities Division
And Industries 324-2640 477-3604
Permits and inspections for on-site septic systems. Spokane Regional Fire spnnkler and alarm systems and private access road inspections, Spokane Valley
Health Distnct 324.1560 Fire Department 892-4122
State law RCW 19 122 requires that pnor to any excavation the -CALL BEFORE YOU Die' center must be notified. Call before you dig at least 2 working days in advance. 456-8000.
PERMIT EXPIRATION AND REFUNDS
All permits shall expire by limitation and be declared void if a) work is not started within 180 days of obtaining a permit, or b) work is
abandoned for 180 days or more after beginning work, or c) after two years from the date of permit issuance, regardless of whether the work is
finished. If a permit is expired for time, a new permit may be obtained for half the permit fee based on the value of the remainder of the work to
finish the original permit
All refund requests must be made in writing by the original permittee to the Building Official no later than 180 days after the date of fee
payment. 100% refunds will be granted for any fee erroneously paid or collected. Refunds of not more than 80% of a permit fee may be
authorized when no work has been done under the permit issued. Refunds of not more than 80% of a plan review fee paid may be authorized
when an application is withdrawn or cancelled prior to the plan review being completed.
Owner / Agent
Date
Jt -/b -tit
Staff Approval Date
SECTION`S INSPECTION CHECKLIST
Note: Checklist to be completed by building department in the jurisdiction home will be located.
YES NO
Home licensed (or applying for license) on or after July 1, 2001 0 0
SLEEPING ROOMS 0 0
Sleeping Room #1 0 S 0 NSI 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside 0 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
Sleeping Room #2 0 S 0 NSI 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside 0 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
Sleeping Room #3 0 S 0 NSI 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside 0 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
Sleeping Room #4 ❑ S 0 NS1 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside 0 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
Sleeping Room #5 0 S 0 NS1 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside ❑ 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
Sleeping Room #6 0 S 0 NS1 0 NS2
Bedroom door is openable from the outside when locked 0 0
Closet doors are readily openable from the inside 0 0
Smoke alarm is installed in the bedroom 0 0
Sleeping room window has a minimum net openable area of 5.7 sf. (minimum dimensions- 24" high; 20" wide) 0 0
Sleeping room window has a maximum sill height of 44" 0 0
GENERAL
Bathroom doors are openable from the outside when locked 0 0
Smoke alarms are installed on all levels of the dwelling ❑ 0
All smoke alarms are audible in all parts of the dwelling upon activation of a single device 0 0
Access road and water supply approved by Fire Department 0 0
0 PASSED
0 CORRECTIONS REQUIRED 0 PERMIT REQUIRED
INSPECTOR: DATE:
Application and Inspection Checklist developed by Washington Association of Building Officials (WABO), in
cooperation with Department of Social and Health Services (DSHS) for use by both departments and licensors.
APPLICATION AND INSPECTION CHECKLIST - Adult Family Home
Code References: 2006 IRC Section R325 (WAC 51-51)
APPLICATION NUMBER:
Applicant must complete sections 1, 2, 3, and 4. Application must be complete to be processed.
SECTION 1 - PROPERTY INFORMATION
SITE ADDRESS: /Z012 �=L X �.! L f l V C ASSESSOR'S TAX/PARCEL #:
SECTION 2 - APPLICANT INFORMATION
PROPERTY OWNER NAME: :Tx e.5 L O u Q 1 l DAYTIME PHONE: 7 L/ '1 — 3 3
LICENSEE NAME (IF DIFFERENT):
DAYTIME PHONE:
SECTION 3 — FLOOR PLAN
A complete floor plan must include all sleeping rooms, identified by number (#1, #2, #3 etc.) and all components for
exiting, i.e. stairs, ramps, platform lifts and elevators. (Attach additional sheets if necessary)
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SECTION 4 — DISCLAIMER/SIGNATURE BLOCK
1 certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and that I am requesting or
I am authorized by the owner of the above premises to request inspection for the operation of an Adult Family Home at this location. I further
certify that I have made application to the Department of Social and Health Services for an adult family home license and that I have also made
application to the applicable jurisdiction for the appropriate license(s) to conduct such business at this location. I further agree to hold harmless the
jurisdiction conducting such inspections, at my request, as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation
of such claim), which may be made by any person, including the undersigned, and filed against the jurisdiction, but only where such claim arises out
of the reliance of the jurisdiction, including its officers and employees, upon the accuracy of the information supplied to the jurisdiction as a part of
this application,
NAME/TITLE:
❑ PROPERTY OWNER d APPLICANT 0 LICENSEE
DATE: fl—it _% g-