2003, 07-31 Permit App: BLD-03-02140 Residence(.7zty of
SPOKANE VALLEY
!S C E i v z
JUL 3
USi1LI.fi
PERMIT #
BUILDING PERMIT APPLICATION
(R 003 CP
fr (pri(-.0037
cv
3ox.1 OWNER \�o cr,'c. o,. Cm:' .- JOB LOCATION \`,\\_,, Cu(:., �'
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB �� \3\� cc
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP. V
30X 2 CONTRACTOR'S NAME ��� �z ,�n� [; ,� PHONE `p�'1; ` Lk -
CONTRACTOR'S ADDRESS j • �2cc c Q � CITY Q\/,-cw
CONTRACTOR'S REG.#EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VEF FIED)
SOX 3 CONTACT PERSON OF PROJECT CN— c ,' 5��� PHONE NqL�ok'Sac
ADDRESS �. S\� feces Cy CITY �sw�ce.o
ZIP `'\
IOX 4 SEWER AVAILABILITY
WATER AVAILABILITY
IOX 5 ESTIMATED PROJECT COST $ \ , CEJ EXISTING BLDG. VALUATION $
1OX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) 6,
• CENSUS NUMBER(it() /
LOT NUMBER
OX 7 BUILDING SQUARE FOOTAGE (Existing
3RD FLOOR / OTHER
BASEMENT UNFINISHED /
/
1ST FLOOR \'„M / 2ND FLOOR
BASEMENT FINISHED /
DECK cS,0 / GARAGE l °SCD. /
CARPORT / TOTAL /
OX 8 (1) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
HEIGHT TO PEAK OF BUILDING \ , FT.
_L-
( VJ NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY \L.17)0
IMPERVIOUS SURFACE )-100
SQ. FT.
SQ. FT.
DX 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
)X 10
tl
Vrater Service meter size (if known) Also see BOX 4
)X 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)
)X 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
'ERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
)RRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
30VE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
NNER/AGENT
DATE \- `S�\- 2)
(OVER)
I be' eb3 authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa iastercard _
_-- ---- ---- -- _____ Expiration Date
Print ttlu :tame of the Holder
Signature
---------------------------------------------------
------------------------------
OFFICE USE ONLY -PLEASE ----------------
--------========================================================
- ------
DO NOT WRIT ---______
--------------- E BELOW THIS LINE
ZONE SETBACKS: FRONT _________________________________________________
SIDE REAR
HEIGHT LIMIT
PLAN(;ING DEPARTMENT APPROVAL
REMAkKS
DISAPPROVAL
DATE
SEPA: EXEMPT
_=_____- NOT EXEMPT
-------__--
FIRE D' P/`.RTMENI!,PkPPROVAL -
DISAPPROVAL
REMA':::;
DATE
PUBLIC', ,'ORKS DEPARTMENT APPROVAL _______________________________
DISAPPROVALDATE
--------------==========================
TYPE G' JOB: NEW RESIDENCE RES. ADD/ALTT -
NEW INDUSTRIAL IND. ADD/ALT
NEW CC; .1, f ERCIAL COMM. ALT/ADD
-----_NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP.
—_— ROOF OTHER
OCCuJf\ (Y
TYPE OF CONSTRUCTION
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
TOTAL SQ. FT.
BUILD:: C : ): _; MIT Np. PLAN CHECK FEE REC'D
PERM! r-:::
PLAN CHECK FEE PLUMBING FEE
MECH. FEE
WSBCC SURCHARGE . ENERGY SURCHARGE
OTHER Cf' ;GES ;I
AMOUNT DUE
TOTAL FE-
TOTAL VALUATION
•
STORIES
RECEIPT NUMBER
ILDING D PARTM;NT APPROVAL
ASSIGNED ADDRESS
BY
DATE
Spokane
�/�Mdlley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: \-‘,,.....A� ,.
\
PERMIT
USE:
OWNER
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city/state) (ZIP)
CONTRACTOR:
\
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH ❑
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
\
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
550
-
4
UNLISTED APPLIANCE (ADDMONAL FEE)
> 400,000
X
5100
=
5
USED APPLIANCE (WSEC min. AFUE rating)
- or < 400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
-
7
BOILER/REFRIGERATION
1 - 100M BTU
X
515
-
8
BOILER/REFRIGERATION
101- 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501-1,000M BTU
X
539
-
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
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)
-
X
51
-
18
DUCT SYSTEMS
-
X
810
-
19
VENTILATING FANS
-
4-
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
512
-
21
AIR HANDLER (DOES NOT indude ducting)
> 10,000 CFM
X
$19
=
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
$50
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
812
-
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
$60
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
525
-
,IES
rte.SI1t
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
4ETHOD OF
] CASH
ATE:
CIIY OF
Spokane
. 0, Valley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PLUMBING FIXTURES
DESCRIPTION
DETAILS
PROJECT
ADDRESS: \�\�s,
X
PERMIT
USE:
OWNER: \
.. \
wG
PHONE (Daytime Contact):
MAILING ADDRESS:
WATER CLOSET, BIDETS
(street)
(city/state)
(ZIP)
CONTRACTOR:
2
LICENSE #:
MAILING ADDRESS:
X
PHONE #:
-
3
(street)
(city/state)
(ZIP)
PLUMBING FIXTURES
•
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
2
URINALS
X
$6
-
3
TUBS
1—
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
k
X
•$6
-
6
DISHWASHER
1
X
$6
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
\
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
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
r.
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
RP.B.P.D. FOR: VATS, TANKS, BOILERS
X
-
17
SPRINKLER SYSTEM
X
825
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
56
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
56
-
PAYMENT
] CHECK
r4: .6 1d:
_ .--•_-_.. _
c.
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
• ■
PVDTD
TOTAL PERMIT FEE DUE:
•
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
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Site Information
Site Address: 1316 S PERRINE RD
SPOKANE, WA 99206
P;.rccl Number: 45214.3322
Su bdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: HOMESTEAD CONSTRUCTION
Address: 312 S FARR RD
SPOKANE WA 99206
Bu ilding Inspector: BOBBY STONE
Water Dist:
Project Information;..
Project Number: 03005389 Inv: 1 .. Issue Yate:'
Permit Use: SEWER CONNECTION - VALLEY PINES h''
Applicant: HOMESTEAD CONSTRUCTION
312SFARRRD
SPOKANE WA 99206 , uiPhon4 e:‘ (509) 892- 454
Contact: HOMESTEAD CONSTRUCTION
312 S FARR RD
SPOKANE WA 99206 nom ,,(509) 892-0454
Setbacks - Front: Left: Right: - Rear
7/2 /2003
Group Name:
Project Name:
Permits
b
Server Connection Permit
Contractor: FOLSOM EXCAVATING INC Llcerue #: FOLSOEI994D0
SEWER CONNECTION i 1 $85.00 PROCESSING FEE
$15.00
i t - , )-
Total Pe1� I T
FOR SEWER INSPECTIONS CALL (509) 477-3604 .UTIL111hS :3p-I;Fo PM MONDAY THRU FRIDAY
CaII for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRED.
Contractor or applicant is to field locateend confirm the elevation and position of sewer stub prior to any other exca(ratioa t °dt'" `r ''''''''43' •
$100.00
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to tliem Vii•
Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure. j
This permit must be presented to the job site inspector for verification. To locate buried cables, gas piping, water lines'etc.' rrt riot I',18::‘"?/-,
l:�^1: ' •
CALL BEFORE YOU DIG, (509)456-8000.' Ot n
STATE LAW RCW 19.122 REQUIRES THAT PRIOR. TO, ANY EXCAVATION TUB -TALL BEFORE YOU DIG" CENTER BE
NOTIFIED. CALL BEFORE YOU DIG AT LEAST ORIONG DAYS IN ADA N (509)456-8000. ;, • ;trli,+,, % -),Fi r
Spokane County Code requires the installer comply with all requirements of the W State Dept of Labor and Industries, including
th )se related to trench safety. & ;d,'
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Processed By: SHATTO, JULIE
Printed By: WENDEL, GLORIA
Tran Date
7/29/2003
Page 1 of 1
b ... N
Receipt ## - : Payment Ami
4756 5100.00 a r+r.;;;.sr . , : .-$14!•1111'
rn
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