2005, 03-22 Permit App: 05000871 RemodelProject Number: 05000871 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 03/22/2005 Page 1 of 2
Project Information:
Permit Use: CONVERT ATTACHED GARAGE TO COMPUTER Contact: STONE JR, J W
ROOM, LAUNDRY & BATHROOM Address: 8209 E NORA AVE
C - S - Z: SPOKANE VALLEY, WA 99212-2519
Setbacks: Front Left: Right: Rear: Phone: (509) 926-1983
Group Name:
Site Information: Project Name:
Plat Key: 002335 Name: SANTA ROSA PARK BLKS 13 & 14 District: H
Parcel Number: 45073.1505 Block:
SiteAddress: 8209 E NORA AVE
Location:: CSV
Zoning: B-1
Water District:
Area: ,072.00 Acres
Neighborhood Business
Lot:
Owner: Name: STONE JR, J W
Address: 8209 E NORA AVE
SPOKANE VALLEY, WA 99212-251
Hold: ❑
Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: - -
Review
Plan Review
Released By:
Permits: ,
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq FI Valuation Su Ft Valuation
RESIDENCE R-3 VB REMODEL 0 $5,000.00 0 $5,000.00
EXISTING
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Operator: K_C
Totals: 0 $5,000.00 0 $5,000.00
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Printed By: MT
Fee Amount
$111.25
$4.50
$44.50
Permit Total Fees: $160.25
Print Date: 03/22/2005
Project Number: 05000871 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 03/22/2005 Page 2 of 2
Contractor: OWNER
Item Description
VENTILATING FANS
CLOTHES DRYER
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
CLOTHES WASHER
Mechanical Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
2 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Fee Amount
$20.00
$10.00
$30.00
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
1 NUMBER OF
NUMBER OF
NUMBER OF
NUMBER OF
Permit Total Fees:
Fee Amount
$6.00
$6.00
$6.00
$6.00
$24.00
Notes:
Payment Summon,-
Permit
ummonPermit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$160.25
$30.00
$24.00
Invoice Amount ,
$160.25
$30.00
$24.00
$214.25
$214.25
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$160.25
530.00
$24 00
$0.00
$214.25
D isclaim er:
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: KS Printed By: MT
Print Date:
03/22/2005
CITY 017
Spokane
4,00Valley
- • • BUILDING PERMIT APPLICATION WORKSHEET
City 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
REQUIRED SITE INFORMATION
Street°Ad-dress: •25 to % go R4
Assessor's Tax Parcel Number(s):
Legal, Description:
PERMIPDESCRIPTION: Y �� Re_ clef
Building P it ❑ Change in Use ❑ Grading ❑ Manufactured Home
Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: 1/0% c ,
Phone: 9RL-,q 3 Fax:
Address:
SerokT7..c zol. ?f2/2_
Cly State Zip Code
Contract6r:
Phone:
-7-r7 iSt:wre
Fax:
Address:
3/ok, „ � 4- 942 z� Lila 9,217
laity State Zip Code Ci State Zip Code
WA State Contractor License #: Contact:
®
Applicant:- ..5";i77 8Lt0
Phone: y'2/e - j -5 Fax:
Address: 21 2o? tito RA
City
State Zip Code
❑ Architect:
Phone: Fax:
Address:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
•.2"FLOOR SQ. FTG:
-UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ- FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF F,OJE
7 %��
30% SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC
SYSTEM?
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
Valuation: Above/Underground Storage Tank Size:
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ WELDING
DISCL-AIMER--
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 tie property owner.
•Print:Name'4J 4—
Signature_,
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address:
• Owner:
Mailing Address:
Contractor.
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
Mailing Address:
City
License #: -
State Zip Code
Phone #:
City
State
Zip Code •
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
P OF UNITS
X
. COST •
_
'TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56 00
=
2
URINALS
X
5600
=
3
TUBS
X
5600
4
SHOWERS (PER TRAP)
BATH STALL, ONSITE BUILT
1
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD. PREP/CULINARY MEAT
)
X
56.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
- 1
X
56.00
B
GARBAGE DISPOSAL -
X
56.00
=
9
WATER SOFTENER
X
5600
=
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
DRAINS
.
-
X
5600
=
13
FOUNTAINS. DRINKING
X
5600
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
- REVERSALS
X
56.00
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
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D FOR' VATS, TANKS. BOILERS
X
56.00
=
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
21
PRIVATE SEWAGE DISPOSAIJSYS
-
X
520 00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH ❑CHECK. 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION•
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address:
Owner:
Mailing Address
Contractor:
Mailing Address:
Community Development Departmen
Building Divisior
11707 E. Sprague Avenue, Suite 10E
Spokane Valley, WA 9920E
Permit Use:
Phone (Daytime Contact):
Cuy
License #:
Slate
Phone #:
Z p Code
State
Zip Code
AUTHORIZED SIGNATURE.
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
5t2.00
2
FUEL BURNING APPLIANCE
More than 100,000
X
515 00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X '
5100.00
7
'BOILER/REFRIGERATION
1 - 100M BTU
' X
512.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1 000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001 - 1 750M BTU
X
535.00
=
'
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560 00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
=
13
RANGE
X
51000
=
14
DRYER
I
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
=
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
' '
X -
510 00
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM .
X
512.00
=
,
21
AIR HANDLER (DOES NOT Include ductng)
Greater than 10,000 CFM
X
515 oo
=
22
EVAPORATIVE COOLERS
-X
510.00
23
TYPE IHOOD
X
55000
=
21
TYPE 11 H000
X
510,00
=
25
HEAT PUMP/AIR CONDrrIONER
0-3 TON
X
512.00
=
26
.AIR CONDITIONER
3-15 TON
X
52000
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
28
AIR CONDITIONER _
30-50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510 00
31
WOOD OR PELLET STOVE/INSERT
X
510,00
=
32
WOOD STOVE - FREE STANDING -
X
525.00
=
33
REPAIR & ADDITIONS
-
X
515.00
=
34
VENTILATION SYSTEMS
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR — RESIDENCE ?
X
$19.00
=
37
INCINERATOR — COMMERCIAL
X
522.00
=
'
METHOD OF PAYMENT:
.D CASH 0 CHECK 0 VISA 0 MC
CARD 1:
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE.