2004, 09-23 Permit App: BLD-04-07735 Residence400,
Street Address:
CAVE
2i 2004
4
BUILDING PERMIT APPLICATION WORKSHEET
it of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
.13111 5, .Me e DT j A- L -D C.►�`�..
Assessor's Tax Parcel Number(s):
Legal Description: L -CT H f .ClC 5 P'!PJ F RE YK i f.D?-U D.•( D
PERMIT DESCRIPTION:
❑ Buiiding Permit
[1 Relocatiott [I Tonant Improvement pi Fire Safety I O• ther
❑ Change in Use ❑ Grading ❑ M• anufactured Home
01t' NERJAPPLiCANT INFORIVIATION
❑ Owner:
Phone: Fax:
Address:
❑ Applicant:
Phone: Fax:
Address:
City State Zip Code City State Zip Code
Contractor:
Phone:
Address:
Fax:
Architect:
Phone:
Address:
Fax:
City State Zip Code City -
WA State Contractor License #:
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK
DIMENSIONS: 50 X s&
# OF STORIES:
MAIN FLOOR TO SOSFTG :
2"" FLOOR SQ. FTG: j- q f
UNFIN BASEMENT SQ. FTG:,..1
/
FINISHED BASEMENT S�Q
G:
GARAGE SQ: FTG: 6. / ,jJ
DECKIOeV PATIO�FTG:
le
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
MEATS SOURCE. . ,
# OF BEDROOMS:
TOTAL HABITABLE SPACE:� /,5
IMPERVIOUS SURA5gEA:
-
COST OF PROJECT:
30% SLOPES ON PROPER :
EWER R ON-SITE SEPTIC
CS
JY.i ?
MANUFACTURED HOME
Width:
Manufacturer
Length: Year: I
Pit Set ;
RELOCATION,��;
Previous Address:
Proposed Use:' -
FIRE SAFETY
Fire Sprinkler:
Tent:
Valuation: Above/Underground Storage Tank Size:
# of Heads: Fire Alarm: Paint Booth:
Date/Time:
Fireworks Display: Blasting:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
1
Plans Examiner:
Phone:
Address:
Inspector:
Address:
Fax:
city
Phone:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
Inspector(s):
❑ REINFORCEMENT
Phone:
❑ WELDING
Fax:
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
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
❑ Check
❑ Mastercard
Bankcard #:
❑ VISA
Expires:
9 Other
VIN#:
SOT() an`
#Malley
ProjectA••j s: /0I 1 / / JC' 1.
Owner /a / 4 i -I c� inI
Mailing edd -s : affiagirialLWMAC
Contractor. 1a P J --
Mailing Address:
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509)688-0036: Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use:
PoneDa ime Con ct):
( it r /
sral -71- 5
State Zip Code
"??
•
License #
�vJ--
DESCRIPTION OF WORK
0OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal 10 or Tess than 100 000
More than 100,000
Equal to or less than 400 000
More than 400 000
/
- -
X
X
X
X
X
X
X
515.00
519.00
550.00
$100.00
550.00
5100.00
515.00
=
=
=
=
_ '-
-
=
..
2
FI IEL BURNING APPLIANCE
3
UNLISTED APFI IANCZ (Additional Fee)
4
UNI ISTED APPLIANCE (Additional Fee)
-
5
C3ED APPLIANCE(WSEC min, AFUE
rat
-
Equal to or less Can 400.000
37..7e than 400,000
1 - 100M BTU
6
o)
USED APPLIANCE (WSEC min. AFUE
piing)
7
BOILER/REFSIGERATION
8
BOILER/REFRK'ERATIOH 101- 500M BTU
X
528.00
=
9
BOILER/REFRICER.'. 101.1
... :,UnOM BTU
X
539.00
=
10
BOILER/REFRIGERATION
1,001 - 1 750M BTU
X
557.00
=
11
BOILER/REFRIGERAT1ON
More than 1,750M BTU
-
X
X
595.00
51000
=
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
13
RANGE
/
X
51000
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
X
510 00
16
MISC. FUEL BURNING APPLIANCE
X
51000
=
17
GAS PIPING (each outlet)
X
51'00
16
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
VE
/
W
X
$10 00
=
20
AIR HANDLER (DOES NOT indude ducting)
Equal to or less than 10 000 CFM
X
512.00
=
21
AIR HANDLER (DOES NOT indude ducting)
Greater than 10,000 CFM
X
519.00
=
22
EVAPORATIVE COOLERS
X
510.00
=
23
TYPE I HOOD
X
550.00
=
24
TYPE 11 HOOD
/
X
510.00
=
25
HEATPUMP/AIR CONDITIONER
0-3TON
/
X
512.00
=
26
AIR CONDmONER
3-15 TON
X
520.00
27
AIR CONDITIONER
15-30 TON
X
525.00
=
28
AIR CONDITIONER
30.50 TON
X
535.00
29
AIR CONDITIONER
Mom than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
-
X
510.00
=
31
WOOD OR PELLET STOVE/INSERT
X
510.00
=
32
WOOD STOVE -FREESTANDING
X
525.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
,.wnn w- - •
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
Smgc
# ey
Project Addry ss: 70
Owner, p / / . .. Sail
ail
Mailing Address: 0 0/, I q'
. A
Is: 17 b 14
a
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use:
Phone (Daytime Contact):Q Lf 1519
cnarq
City 01
�/ K /1 Stated Zip Code
1
11'1 %onle #: /[p -a077
/r
Contractor.
Mailing Addr
1 nse #:
City
State Zip Code
BANKCARD NUMBER
---"71�mT1ORIZEI SIGNATURE
DESCRIPTION OF WORK
MOF
UNITS
X
COST
••
• TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
'I
X
56.00
=
2
URINALS
3
TUBS
3
X
56.00
.
4
SHOWERS (PER TRAP)
BATH. STALL, ON-SITE BUILT
3
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD.
PREP/CULINARY/MEAT
�J
'/
X
56.00
=
6
DISHWASHER
/
X
56.00
=
7
CLOTHES WASHER
/
X
$6.00
=
8
GARBAGF DISPOSAL
L
/
X
56.00
=
9
WATER SOFTENER
X
56.00
_
,
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH.
CONDENSATE
/
X
56.00
=
12
ROOF DRAINS/OVERFLOW GRAINS
X
58.00
=
13
FOUNTAINS, DRINKING
X
56-0
_
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
58.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER
CARBONATOR, SWAMP COOLER
!�
J
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE AND RP.B P.D. FOR'
VATS, TANKS, BOILERS
X
58.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK ❑ VISA 0 MASTERCARD
DATE - EXPIRES:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER
---"71�mT1ORIZEI SIGNATURE
n
Two Story Line 'h
Gas/Elec\\\
Ur,dergroQ�%-
0
10
20
40
SEEIEMB 2QQ3
Tills Ail plan Is being sttbnYtto0 tow prep of
obtaining a todldbrg panne and b a tie and and
representation of the proposal. MI known ply
IMesitene Mone cure ones. soigne rid Doom
have bean 'T1' . Also hrdbaladvitt.
Podia of • • . . • • eines .
Signed: 4 :74111.4...-la.P..€.P..€4 _ .
' -a; -o
exing on omes
PINE ROCK RIDGE 1ST ADDITION
LOT 3 BLOCK 5
Founded 1946
timpson Engineers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
PHONE (509) 926-1322 FAX (509) 926-1323