2003, 10-02 Permit App: BLD-03-02647 Residence1
1
*lane
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707 East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: (509)688-0036 Fax: (509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: 35-p4 S. en
'bQ*c(
ASSESSOR'S TAX PARCEL NUMBER(S): #2&(164072°7
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LEGALDISCRIPTION: LafigALK3 likkULbrAg.
MST 3� A -OD
PERMIT DESCRIPTION: 2t5 1 D 6A)ce
BUILDING PERIVLIT 0 CHANGE IN USE
RELOCATION
® SIGN
® GRADING
0 TENANT
0 MANUFACTURED HOME
}OTHER
OWNER / APPLICANT INFORMATION
® OWNER:
PHONE: FAX:
ADDRESS:
qq
CITY,STATE, ZIP
CONTRACTOR: 61 I FF �!'F7/� I/TL �r ® ARCHITECT:
PHONE: 414 -7733 FAX:
n»9 1t-�9U'7 l�r�]p��PHONE:
ADDRESS: 11&ca, 6. SE�Tt+ R+t Q 4ZPO'�"-ADDRESS:
CITY, SJ�JO, Ip W4 - CITY, STATE, ZIP
WA ST CONTRACTOR LICENSE # C4.1 I�FSt !by kr CONTACT: CF.(
APPLICANT:
PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
FAX:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TO PEAK: 1
(0,
BUILDING DIMENSIONS:3OS*'
NUMBER OF STORIES: (qq
NUMBER of BEDROOMS: C/
FLANKING SETBACK:
FRONT SETBACK: z�
REAR SETBACK: 57
LEFT SETBACK: �Z
RIGHT SETBACK:
/0
30% SLOPES ON PROPERTY: - t,J�
OCCUPANCY GROUP.
CONSTRUCTION TYPE:
STRUCTURES ON PROPERTY: Note
CRITICAL AREAS:
CURRENT PROPERTY SIZE: /Q q33
CURRENT PROPERTY USE: Nocdit
CURRENT SEPTIC USE: A)MAte-
CURRENT WELL USE: AJU'A/ Z
IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT: /TV
2ND FLOOR SQ FT:
UNFIN BASEMENT: /SS7
FINISHED BASEMENT: -Q -
GARAGE: 700
COVERED DECK: •-.0"'
DECK:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN: HEIGHT OF SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION
FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
® BOLTING
FIRM NAME:
INSPECTOR(S): .\
°CONCRETE
.CI REINFORCEMENT- 1 • ' l® -WELDING
PHONE:' •
FAX:
BUILDING STAFF USE ONLY
IS PUBLIC SEWER AVAILABLE: ® YES I] NO
0
IS PUBLIC WATER AVAILABLE: YES ®NO IF YES, WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: CI YES • NO PSSA: •YES 0 NO
IF YES: • COUNTY • CITY
1
DATE:
1
STAFF:
METHOD OF PAYMENT:
CASH CHECK
BANKCARD 40; EXPIRES: VINE/
AUTHORIZED SIGNATURE.
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
VISA
Spbgkanka ems'
Walley
Mechanical Permit Application
11707, Eat Sprague Avenue, Suite 106 509-688-0036 - Phone
509-688-0037 - Fax
Spokane Valley, WA 99206
PROJECT ,n/
ADDRESS: .S.114 ,rye S. 1 e cOON (dQ.
PERMIT '
USE: - ,
OWNER
1 OF UNITS
PHONE (Daytime Contact).
MAILING ADDRESS:
EQUALS
AMOUNT
(street)
(city/state)
(ZIP)
-
CONTRACTOR: p 5 U L R/ 771 p
(, �`C �/��lC
71Cki
kariN 6
LICENSE P:
.
MAILING ADDRESS: -
2
PHONE #:
' > 100,000
X
(street)
(city/state)
(ZIP)
METHOD OF PA
❑ CASH 0
DATE: EXPIRES'
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
f
X
515
•
2
FUEL BURNING APPLIANCE
' > 100,000
X
519
•
3
UNLISTED APPLIANCE(ADDITIONAL FEE)
•OR<400,000
X
550
•
4
UNLISTED APPLIANCE (ADDRIONAL FEE)
> 400,000
X
5100
•
5
USED APPLIANCE (WSEC min. AFUE rating)
r <400,000
X
550
•
6
USED APPLIANCE (WSEC min AFUE rating)
>400,000
X
5100
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
•
8
BOILER/REFRIGERATION
101 - 500M BTU
X
525
-
9
BOILER/REFRIGERATION
501- 1,000M BTU
X
539
•
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
' 4-1750M BTU
X
595
•
12
GAS LOG, CAS INSERT, GAS FIREPLACE
` -
I
X
510
•
13
RANGE
-
X
510
•
14
DRYER
-
X
510
•
15
FUEL BURNING WATER HEATER
-
'
X
510
•
16
MISC. FUEL BURNING APPL -
' -
X
510
•
17
GAS PIPING (ea Outlet)
-
3
X
51
•
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
3
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
• OR <10,000CFM
X
512
21
AIR HANDLER (DOES NOT Indude ducting)
> 10,00 CFM
X
519
•
22
EVAPORATIVE COOLERS
-
X
510
•
23
TYPE I HOOD
-
X
550
-
24
TYPE II HOOD
-
I
X
510
•
25
HEAT PUMP/AIR CONDITIONER
03 TON
X
512
-
26
AIRCONDT2ONER
3-15 TON
X
520
•
27
AIRCONDITTONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
535
-
29
AIRCONDITIONER
+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
•
HENT
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
... .I
VISA' j._ _,� ,,
TOTAL PERMIT FEE DUE:
DATE: EXPIRES'
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
METHOD OF
0 CASH
DATE:
*lane
.0,0Valley
Plumbing Permit Application
11707 East Sprague Avenue,, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
• 509-688-0037 - Fax
PROJECT ADDRESS: s i
i J,
7 S. 6 t 1 e ort a �(j(
USE: PERMIT
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
1
(street)
(city/state)
(ZJP)
CONTRACTOR.
mm -( �J s }AL/tuna/me
LICENSE #:
^ —
MAILING ADDRESS:
PHONE It
X
$6
(street)
(city/state)
TUBS
(ZIP)
PLUMBING FIXTURES
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6
-
2
URINALS
X
$6
3
TUBS
7j
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
'
X
$6
-
5
SINKS
LAVS/BASINS, BAR, FLOOR KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
J
X
$6
-
6
DISHWASHER
I
X86
.•
7
CLOTHES WASHER
I
X
8
GARBAGE DISPOSAL
X
§6
-
9
WATER SOFTENER
X
$6
-
10
ELECT HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
I
X
S6
-
12
FOUNTAINS, DRINKING
X
S6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
_
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE BIB,
STEAMER, PROOFER, CARBONATOR
SWAMP COOLER
X
$6
•
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
RP.B.P.D. FOR: VATS, TANKS, BOILERS
X
'
17
SPRINKLER SYSTEM
X
$25
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK -
X
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
E6
-
20
MLSC. PLUMBING FIXTURE
X
$6
•
PAYMENT
] CHECK
YIS9'
-
.__.�
SUBTOTAL:
'
PLUS PROCESSING FEE:
$35.00
■ -' .. - ■
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
S00.14'25'W
GRAPHIC SCALE QN FEET)
0 10 20 40
1' = 20'
This is not an as -built drawing.
Any modifications to this plan aft
the date onthe Engineer's stamp
VOIDS the Engineer's stamp.
September, 2001
LOT 8, BLOCK 3
MIDILOME EAST 3rd ADDITION
r_ ws
lahmpson Engineers, Inc.
aw. ENGINEERS & LAND SURVEYORS
N.909 ARGONNE ROAD
SPOKANE. WA 99212 PN 826-1322
S00'14'2514
85.00
z,,"
WAs
'6,401
q (1to '
kisallsr96c._ so
I
30' 30' Building Setback -...,,j
20' Drainage and Utility Easement , 0
I
rn
0
I N89.45'35'W 03 t
k>j
BO�REs ! 7/17103
_
N
8
ookASE
263
9
1,
...-
nu
IO
111
6 AR. AGE
-e
1 :
_ _
10'
—
_ ..
P
e
•.=• 24'
Dr' way
e -.
5' Sidewalk.
'a'
85.00 // R/W Line
»: ya/a Tit '. R!!7a\\\\\
... - . . •
-10
\
%"----
-
N
"°
Swale Bottom. 2 wide J Curb Line
McDONALD STREET
S00.14'25'W
GRAPHIC SCALE QN FEET)
0 10 20 40
1' = 20'
This is not an as -built drawing.
Any modifications to this plan aft
the date onthe Engineer's stamp
VOIDS the Engineer's stamp.
September, 2001
LOT 8, BLOCK 3
MIDILOME EAST 3rd ADDITION
r_ ws
lahmpson Engineers, Inc.
aw. ENGINEERS & LAND SURVEYORS
N.909 ARGONNE ROAD
SPOKANE. WA 99212 PN 826-1322
7
N89'45'35'4/
7
M
N
N
10'
5, Tril
S00'14'25'W
- 4
24'
N89'45'35'W
EXPIRES 7/17/ 03
woy
e-
9
•
• 4:
1n
5' Sidewolk
• y .a
85.00
Swale Bottom, 2 wide
McDONALD
GRAPHIC SCALE (IN FEET)
0 10 20
1' = 20'
S00'14'25nd
R/W Lin
Curb Line
STREET
This is not an as—built drawing.
Any modifications to this plan after
the date on the Engineer's stamp
VOIDS the Engineer's stamp.
-�
September, 2001
LOT 8, BLOCK 3
MIDILOME EAST 3rd ADDITION
r4. ae Nab
mpson Engineers, Inc.
CIVIL ENGINEERS & LAPD SURVEYORS
N.909 ARGONNE ROAD
SPOKANE. WA 99212 PH 926-13n