2003, 07-09 Permit App: BD-03-742 ResidenceohUne 11707 E. SPRAGUE, STE 106
SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
PROJECT TRANSMITTAL:
TRANSMITTAL DA 1b:
SITE INFORMATION • PERMIT INFORMATION
Site Address: 13 a 5
Parcel Number:
Subdivision:
Block: Lot:
Zoning: Water Dist:
Owner:
Address:
Building Inspector:
Permit Number:60 e 3 ,--74 ?issue Date:
Applicant:
Contact:
Contractor:
1'ect
Phone:
Phone:
Setbacks — Front: Left: Right: Rear:
BUILDINGS:
APPROVALS
7/7
PLANNING:
ENGINEERS:
HEALTH:
SEWER:
k� u
- cpz? 7. 3 0.3
FIRE DIST1 •
WATER DIST:
APPROVALS
>TORMWATER:
)1111,R:
i2 75.L3c
7.L7
3 c, e o6
cJ LI Li
T1
tokS-C15
#71:c c) Re ..
•
co
rte- (.1\
(3zc -
Cizy of
SPOKANE VALLEY
£&' - 003 (p
Fot)( c(i(- 0o37
PERMIT #
BUILDING PERMIT APPLICATION
Box.1 OWNER \-\J �.y „x4 C J JOB LOCATION \� L\
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME "A-�,• -� � C PHONE ` ..-N"c-
CONTRACTOR'S ADDRESS � ��� q� CITY
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VEF IFIED)
30X 3 CONTAC"I PERSON OF PROJECT C� , 5 ati PHONE
ADDRESS
CITY ZIP
30X 4 SEWER AVAILABILITY
30X 5 ESTIMATED PROJECT COST $
WATER AVAILABILITY
EXISTING BLDG. VALUATION $
30X 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMITA SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• CENSUS NUMBER
LOT NUMBER
OX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR \O`t\ / 2ND FLOOR
3RD FLOOR / OTHER /
BASEMENT UNFINISHED \ ' / DECK -1.,N
CARPORT / TOTAL /
OX 8 ( 3) SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
BASEMENT FINISHED
/ GARAGE � /
HEIGHT TO PEAK OF BUILDING :A' FT.
( d) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY SQ. FT.
IMPERVIOUS SURFACE 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 UMTS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPHNKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
it
)X 10
)X 11
----------------
Wz,:er Service meter size (if known) Also see BOX 4
Se )tic 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
OVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
/NER /AGENT
DATE
((WFR)
I hercb y :, uthorize 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 Folder
Signature
__==========================================================
_____________ __
OFFICE USE ONLY- PLEASE p
_ OFFICE ----O NOT WRITE BELOW THIS LINE
____________------
ZONE _--- SETBACKS: FRONT ===================================================== ===========================
SIDE
PLANNING DEPARTMENT APPROVAL
REM',E;KS
REAR HEIGHT LIMIT
DISAPPROVAL
DATE
SEPA: :EXEMPT
NOT EXEMPT
FIRE DEPARTMENI!APPROVAL
DISAPPROVAL
REMARKS DATE
-------- --------------------
PUBIC '/VCRKS DEPARTMENT APPROVAL —
----
DISAPPROVAL
DATE
TYPL Gi Cg: NEW RESIDENCE RES. ADD/ALT NEW INDUSTRIAL USTRIAL IND. ADD/ALT
NEW CO:;;wI,=RCIAL COMM. ALT/ADD
NEW MULTIFAMILY NO. UNITS
MULTI F„::\;'LY ADD/ALT TENANT IMP.
ROOF _�—OTHER
BUILD', IG . ;MIT NO.
PERMIT FE=.
TOTAL FEE;;
OTHER CI i, ,. <C>ES
BUILDING [ '.1RTMNT APPROVAL
TYPE OF CONSTRUCTION
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
BUILDING SQ. FT.
TOTAL SQ. FT.
PLAN CHECK FEE RECD
PLAN CHECK FEE
WSBCC SURCHARGE
TOTAL VALUATION
•
STORIES
RECEIPT NUMBER
PLUMBING FEE MECH. FEE
ENERGY SURCHARGE
AMOUNT DUE
ASSIGNED ADDRESS
• BY
DATE
POKANE>; COUNTY DIVISION OF $UILDI
AND CODE ENFORCEMENT
1026.WEST BROADWAY AVENUE •• SPOKANE� WA 99260-0050'.
Site Information
Project Information
ite Address: 1322 S PERRINE RD
SPOKANE, WA 00000
P:a n el Number: 45214.3321
Subdivision:
Block: 1 Lot: 21
Zoning: UNK Unknown
Owner: HOMESTEAD CONSTRUCTION
Address: 312 S FARR RD
SPOKANE WA 99206
Bu! ling Inspector: BOBBY STONE
Water Dist:
Project Number: 03004627 Inv: 1 Issue Date: 6/27/2003
Permit Use: SEWER CONNECTION - VALLEY PINES
Applicant: HOMESTEAD CONSTRUCTION
312 S FARR RD
SPOKANE WA 99206
Contact: FOLSOM EXCAVATING
16701 E VALLEYWAY
VERADALE WA 99037
Setbacks - Front:
Group Name:
Project Name:
Left: Right:
Phone: (509) 892-0454
Phone: (509) 891-1232
Rear:
L
Sens Connection Permit
Permits
Contractor: FOLSOM EXCAVATING INC
License #: FOLSOEI994D0
SEWER CONNECTION
1 $85.00 PROCESSING FEE
Total Permit Fee:
OR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES 8:30-5:00 PM MONDAY THRU FRIDAY
$15.00
$100.00
Call for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRED.
Contractor or applicant is to field locate and confirm the elevation and position of sewer stub prior to any other excavation.
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main sewer.
Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure.
Chis permit must be presented to the job site inspector for verification. To locate buried cables, gas piping, water lines, etc.
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE "CALL BEFORE YOU DIG" CENTER BE
!NOTIFIED. CALL BEFORE YOU DIG AT LEAST 2 WORKING DAYS IN ADVANCE, (509)456-8000.
Spokane County Code requires the installer comply with all requirements of the Washington State Dept of Labor and Industries, including
those related to trench safety.
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
1'1( cessed By: SHATTO, JULIE
"Tinted By: WENDEL, GLORIA
Tran Date Receipt # Payment Amt
6/27/2003 4109 $100.00
Page I of 1
PERMIT
ETHOD 0
CASH
ntt'cx'
S34kane
,,,if 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
PROJECT
ADDRESS: \'..141- . u-
.`��
PERMIT
USE:
# OF UNITS
X
OWNER:
EQUALS
PHONE (Daytime Contact):
1
MAILING ADDRESS:
WATER CLOSET, BIDETS
'�
X
(street)
(city/state)
(ZIP)
2
CONTRACTOR:
LICENSE #:
X
MAILING ADDRESS:
Ly
PHONE #:
TUBS
A I
X
$6
(street)
(city/state)
(ZIP)
•
PLUMBING FIXTURES
NKCARD NUMBER
THORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
'�
X
$6
-
(-4
2
URINALS
X
-
Ly
3
TUBS
A I
X
$6
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
-
i
S
SINKS
LAVS/BASINS, BAR,FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
:3
X
•$6
-
Le
6
DISHWASHER
\
X
-
7
CLOTHES WASHER
`
X
$6
8
GARBAGE DISPOSAL
X
- ,
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$b
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
-
to
12
FOUNTAINS, DRINKING
X
-
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
-
I
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6•
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
..
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
-
PAYMENT
CHECK
CHECK
VISA'
ilfast;
SUBTOTAL:
gLi a)
PLUS PROCESSING FEE:
$35.00
■ ■
FXPTRFS•
TOTAL PERMIT FEE DUE:
NKCARD NUMBER
THORIZED SIGNATURE:
Spokane
,,,valley
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: \''), Z
S tR,•-,cc ,- .-
PERMIT
USE:
OWNER
\
EQUALS
PHONE (Daytime Contact):
MAILING ADDRESS:
FUEL BURNING APPLIANCE
-OR<100,000
(street)
X
(city/state) (ZIP)
CONTRACTOR:
IC.-
2
LICENSE It:
MAILING ADDRESS:
X
PHONE #:
-
(street)
3
(city/state) (ZIP)
METHOD OF PA
0 CASH 0 CHECK ❑ ❑ L
DATE: EXPIRES:
BANKCARD NUMBER:
AI)T)-inn,7F'TT cl::v T, T-
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
-OR<100,000
‘
X
815
-
IC.-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDMONAL FEE)
- OR <400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL 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
5100
-
7
BOILER/REFRIGERATION
1- IOOM BTU
X
515
-
8
BOILER/REFRIGERATION
101- 500M BTU
X
528
-
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 LOC, GAS INSERT, GAS FIREPLACE
-
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
1
X
510-
Iv
15
FUEL BURNING WATER HEATER
-
\
X
810-
1 O
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
'7
X
51-
2.
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
14c.
X
510-
WO
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
812
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
550
-
24
TYPE II HOOD
-
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
820
-
27
AIR CONDITIONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
535
-
29
AIR CONDITIONER
+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
-
KENT
PISA •
SUBTOTAL:
'-77 eo
PLUS PROCESSING FEE:
•-$Sb.'00�'-
TOTAL PERMIT FEE DUE:
0 CASH 0 CHECK ❑ ❑ L
DATE: EXPIRES:
BANKCARD NUMBER:
AI)T)-inn,7F'TT cl::v T, T-