2003, 05-16 Permit App: BD-03-431 Residenced//UJ/AT.1 u :'L( �n7dL41bb(
[ 1 11707 E. SPRA.CIUE STE .106
' JIMMY SPOKANE VAJJEP, WA 99206
(509)688-0036 FAX (509)688-0037
SIT4INFORIVAMN
TO 3241567 P.02/02
PROJECT TRANSMITTAL:
TRANSMITTAL DATE:
. emmjziffSE) A?ION •
Site Address: ra d7 % •
Parcel Number: Lt.to 3L1'i' • O57)
Subdivision:
Block: Lot:
Zoning: Water Dist:
Owner: /32I A (J V i--
Address: (p j+ NL NE Ltd
Building inspector: 5A . 1-(45
Permit Number: 0-3.-4-1,151 Issue Date:
Permit Use: gEs
Applicant: f3g
AN #4aifK
Coataet: 6441 IJ
i
Phone:
Contrator: C7 W WS'
setbaalib-Front igLeftz7/RightZ Rear: SI.7
Phone: 924- (il-1/
, 'PROVALS
BUILDINGS:93 OZ...44/
PLASH/4t»»4-/5--A 3
ENGINEERS: fed/ 01= �./ 0 1,,-/p ?
f
JUN 30 2003 09:27
** TOTAL PAGE.02 **
5093241567 PAGE.01
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11707 E. SPRAGUE, STE 106
I SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMITTAL:
TRANSMITTAL DA I E:
PERMIT INFORMATION
Site Address: 3.-,; v-7
Parcel Number: Li V3(---1 L... o 577
Subdivision:
Block: Lot:
Zoning: Water Dist:
Owner: 512
Address:' 3t1- E 6 0-1-- Pi NE LN
Building Inspector:
5 -Aro) (-1(4.9F2D \)
BUILDINGS: 67/3--
1_,S7
Permit Number: 03— i4 5) Issue Date:
Permit Use: gF_$ \A A g'
Applicant:LEC- K
6�lAry {40
Contact:'( IJ
Contractor: d(Al ( ,
Phone: 921.1 (�L9
Phone:
Setbacks — Front: /5 Left:27/Right: Rear: 7
APPROVALS
Vic. '`moi 7 (
PLAISq4iNg
/CZ CLQlZ s- /5-- 3
ENGINEERS: fu) p 3 / D
APPROVALS
WATER DIST:
STORMWA(TER:
OTI E
2
Col
z zz
rec,FEzd-
)/40
691('
K5-<1-39 'oa
App iroo 5- 00
927,
Z`�
APPROVED B
z105- 9/6
Afotilev)
Parcel: 46344.0503
Owner:
CoOwner:
Owner Address
Site Address
0 UNKNOWN SPOKANE
Legal Description
34-26-44, WEST FARMS IRRIGATION TRACTS: E 577.53 FT OF
S 153.80 FT OF TRACT 106 TOG W/ N 250.00 FT OF E 577.53 FT
OF TRACT 109, PLAT 4 EXC
RD
Notice: This is not a legal document. Data depicted on this map is general & subject to constant revision. It is intended
for reference use only. Legal documents should be obtained from the appropriate agency.
Sfiokane
4,00Valley
Call 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PW 03-210
APPROACH PERMIT
APPLICATION
Location of property 5,20-7 Iv
(Address/Parc #, if available)
Applicant Name E flc -\ 1-:)t31 'PGe
Address %Z "1 kA 11 ?i-vip Phone 9a,t(--1, �s qI
TAddrContractor's Name CU by LQ-1-
Address
ess Phone
Contractor's Reg# Expires
PROJECT DESCRIPTION (Provide site sketch)
(Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other conditions
Commercial/Industrial Driveway
Rural Road Section
Sidewalk Repair/Construction
See construction requirements and details on reverse. Bond/insurance certification must be on
file with the City.
SPECIAL CONDITIONS:
PERMIT FEE $
Inspection Fee$
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date
Name of Holder
Signature
City of
SPOKANE VALLEY
PERMIT #
BUILDING PERMIT APPLICATION 5.207 Mcu,, (i&J
Box 1 OWNER (iao C (6 f pk JOB LOCATION SSDO acGe-- /II l'✓a &'
OWNER'S ADDRESS
064
OWNER'S t ail me L. -CITY 5(0-40e_ PHONE 'off -/ 0' 9
DESCRIBE JOB 4 1"1'G�Y�eIJ 541.7 `i' / IrOode.j
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
CORP.
PARTNERSHIP
BOX 2 CONTRACTOR'S NAME a`NC'Y feeili oCf
CONTRACTOR'S ADDRESS <!
CONTRACTOR'S REG.#
PHONE
CITY
EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED)
BOX 3 CONTACT gE RSON OF PROJECT] Yiiavi HOCe&el-y PHONE 9r94 -I 9
ADDRESS V6 3c( c i 0ii ,�C' Lase CITY Geeavte ZIP qq i
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ 9a 1> EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER q-6.3‘14 • os -o3
LEGAL DESCRIPTION
o2-"4 ' 0-7
0505• y
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR / 2ND
FLOOR /
3RD FLOOR / BASEMENT / gii) DECK / 020
GARAGE / 746 CARPORT / TOTAL /
BOX 8 (, SINGLE FAMILY ()) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTU$
( ) COMMERCIAL / INDUSTRIAL TOTAL AREA OF PROPERTY 043A oh% SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins)
NO. .3 WATER CLOSETS - URINAL
1 BATHTUBS -FAUCETS
,.1
3 SHOWERS
3 LAVATORIES
6 SINKS
DISHWASHERS
ELECTRIC HOT WATER HEATER
1 LAUNDRY WASHER OUTLET
1 LAWN SPRINKLER SYSTEM
DRINKING FOUNTAINS
SUMPS, SPRINKLER VACUUM BREAKERS
FLOOR DRAINS
BACKFLOW PREVENTER
VACUUM TYPE BREAKER
HOT TUBS
TOTAL FIXTURES
MECHANICAL APPLIANCES
GAS PIPING : OUTLETS
NO. 1 FURNACE, ELECTRIC GASX
(BTU RATING
GAS HOT WATER HEATER
CONVERSION BURNER
BOILER: SIZE
AIR HANDLING UNITS
HEAT PUMPS: SIZE
UNIT HEATERS
1 AIR COOLING UNITS; SIZE I'S IP 3o Ivy
COMMERCIAL HOOD
GAS APPLIANCES
FIREPLACE INSERTS
3 EXHAUST VENT FANS
APPLIANCE VENT REPAIR
WOOD WOESYSTEM
rtzdy
TOTAL UNITS
OVER
(S
/ Z)
3
2
BOX 10 WATER SERVICEMETER SIZE (IF KNOWN) / (ALSO SEE BOX 4)
BOX11 SEPTIC TANK - NOT GENERALLY ALLOWED IN THE CITY OF SPOKANE VALLEY. FOR
SPECIAL CIRCUMSTANCES CONTACT THE SEWER PROVEYOR AND THE HEALTH
DISTRICT. (SEE BOX 4)
BOX 12 STREET USE MAY REQUIRE A "STREET USE PERMIT" FOR SEWER, WATER, SIDEWALKS,
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 PREMISES T RF HE ORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT DATE 5 -13 -03
OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ _
SQ. FT. @ =
SQ. FT. @ =
SQ. FT. @ _
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
ASSIGNED ADDRESS
RECEIVED ACCEPTED FOR FILING
City of
SPOKANE VALLEY
PERMIT #
BUILDING PERMIT APPLICATION
5 2t7a
Box 1 e Rolece16 JOB LOCATION 5900 hock JI. fVlayl eR)
CITY PHONE 0�3 get( P,v;e &fE
I;�icoG &, 6( Toile -1zw;ily Yaoclie S'�c', (�'✓f 9a l 171/,'?de-/-105
OWNER&!,n 4 &cc
OWNER'S ADDRESS
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED �C
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME CIAO fr, PHONE
CONTRACTOR'S ADDRESS CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT ijc:av) I-tokCe- PHONE gdq—ig4q
ADDRESSO6'3' &Il tg1-410e CITY ��hE ZIP 9V a
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY %rcw►v°ocl Trr q cairc,�
BOX 5 ESTIMATED PROJECT COST $ 90,000 EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
C344,050.3
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR / OTHER
BASEMENT UNFINISHED //e00 DECK
CARPORT / TOTAL /
1ST FLOOR /(9XO 2ND FLOOR /
/ BASEMENT FINISHED
/ �/ 1 GARAGE / "Mg
HEIGHT TO PEAK OF BUILDING de FT.
BOX 8 (X) SINGLE FAMILY (JG') NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL / INDUSTRIAL TOTAL AREA OF PROPERTY 022 d06 SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE 2 7 (o8 SQ. FT.
BOX 9 PLUMBING FIXTURES (Including rough -ins) 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) 1 °/
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 PREMISES PERF R THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT DATE 513-D3 3-D3 (OVER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard_ _ _ _ _ _ _ _ Expiration Date
Print the name of the Holder Signature
OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
SEPA: EXEMPT NOT EXEMPT
FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE
REMARKS
PUBLIC WORKS DEPARTMENT APPROVAL
DISAPPROVAL DATE
TYPE OF JOB: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT
NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES
BUILDING SQ. FT. @ =
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ =
TOTAL SQ. FT. TOTAL VALUATION
BUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NUMBER
PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE
OTHER CHARGES
AMOUNT DUE
BUILDING DEPARTMENT APPROVAL BY
DATE
ASSIGNED ADDRESS