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2003, 07-01 Permit App: BD-03-728 Residence'�Mirrw;, ne 11707 E. SPRAGUE, STE 106 all SPOKANE VALLEY, WA 99206 (509)688-0036 FAX (509)688-0037 SITE INFORMATION PROJECT TRANSMITTAL: TRANSMITTAL DA E: PERMIT INFORMATION Site Address: t e (0 Parcel Number: Subdivision: Block: Lot: Zoning: Water Dist: Owner: Address: Building Inspector: Permit Number: Permit Use: Applicant: Contact: Contractor: Issue Date: Phone: Phone: Setbacks — Front: Left: Right: Rear: BUILDINGS: APPROVALS PLANNING: b e ENGINEERS: p t 3 03 4 2 7 HEALTH: SEWER: k n 2? - L to (Qc-/ FIRE DIST WATER DIST: APPROVALS STORMWATER: OTHER: fl o Cr, ____-?•&FI; 3 L're.zi /alas tri: in bFUKHNL. LU bUILVINU LUVt mrum Site Itaforinati On Site Address: 610 N PIERCE RD SPOKANE, WA 99206 PamI Mamba; 451630145 Subdivision: Block: Lot Zonchig: UNK Unknown Goner: JULIANO, TOE Addrgns: 14314 E STOUGHTON' VALLEYFORD WA 99036 • Building inspector: BOBBY sTONE Water Diat: Project Information Project Number: 13300466$ Inv 1 Tissue Date Nail* Use: SEWER CONNECTION - EASTON El 7/142003 AppNcant .111LIAINICk JOE 141314 P.- STOT.B31-1TON VALLEYFORD WA 99036 bone: 009).291-3148 Contact TUTIAN0, JOE 14314 £ STOUGHTON VALLEYFORD WA 99036 Phoue: (509)291-3L4$ Setbacks - Front Left: Right Rear Group Name: Project Name . Permits .11=••••, ,S'over Connection"Permit Cintratior: -LONGP2ir-AvATING License itt; LONGE*07701K SEWER CONN73CTION S85.00 PROCFSSING FEE Toted Pena Fee 1 OW/ Sis.n0 3100.00 FOR SEWER INSPECTION'S CALL (509) 477-36(4 UMIT1ES 8139+50. PM MONDAY THRLT FRIDAY • •. - • . Call for inspection prior to cover, ONE WORKING DAY Nowg REOTARET1. Contractor or applicaat is to field locate and confirm the *ration andlinSitian.dsewer stab pier to any other ezzeavolion. Sewer stubs are to bc checked prior to connection. to ensure tot their have act;eptioble grade and are clear and unobstructed to -the main sewer. Sewer lines should be constructed to allow for gravity flow from theitiedisost'WelOf the structure. This permit must be presented to the job site inspector for verifies:ion. TO loUinc:ituied cadges, ga piping, water lines, eta CAU. . BEFORE YOU DIU, (SO9)456-8000- STATE LAW REW 19,122 RE.Q1J11ES THAT PRIOR TO AN* EliCgiiAtON TALL BEFORE YOU DIG" CENTER EKE NOD:MD. CALL BEFORE YOU DIG AT LEAST'2 VORKINCI DAY!SINADWs..NC509)456-8000, Spokane County Code requires ttke installer ccitupl Witia all ietittir4rteritsofthc *.aSkinitott,te Dept of Labor and Industries, including those related to trench safety. • TotalPoes ' $10000 AntoantPaid $100.00 tiaVviient SOmmary Matvitowillst $0.00 - itsp,te Rece;tit # formatAnit 7/1i7001 • 4147 $100.00 Processed By SHATTO, TOLJE Printed, By WENDEL, GLORIA Page 1 or 1 PERMIT EIOD OF kSH Scrrt cxkane r�r� 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: DESCRIPTION DETAILS PERMIT USE: OWNER: Q + li ,A1 t .3 o O PHONE (Daytime Contact): a4, 3iii 8. ", 95/gT 7� MAILING ADDRESS: E 14314 5#0"001+" VQ.))eycocie i-0/9 99034 (street) TOILETS !city/state) (ZIP) CONTRACTOR: R` +5 fu m I b J� / C� LICENSE #:RI t c 1c S PH / l� 3 0 T MAILING ADDRESS: Po L3 3 "79 2 dC Spok'o 0 e PHONE #: £ 9 5- ci i I,)/?- q9a ?b (street) $6 (city/state) (ZIP) ' PLUMBING FIXTURES :CARD NUMBER: [ORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6 -Le 2 URINALS X $6 - 3 TUBS 1 X X $6 $6 n Le 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 3 X $6 = Q I Q 6 DISHWASHER / X $6 = 7 CLOTHES WASHER 1 X X $6 $b = l.f' 8 GARBAGE DISPOSAL 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 X $6 12 FOUNTAINS, DRINKING X $6 = 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING . REVERSAL1 INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 = A 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 = 1: a 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 $6 = 20 MISC. PLUMBING FIXTURE X $6 = PAYMENT ] CHECK ' 1i 151 —_ • SUBTOTAL: ( 1' UV PLUS PROCESSING FEE: �35:60 ■ • TOTAL PERMIT FEE DUE: :CARD NUMBER: [ORIZED SIGNATURE: Soracie .Valley 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA .99206 509-688-0037 - Fax For Inspections, call 509-688-0054 Mechanical Permit Application METHOD OF PA ❑ CASH ❑ C DESCRIPTION OF WORK PROJECT ADDRESS: X PERMIT USE: OWNER DI d (J `1 1_I cry) n \ AMOUNT PHONE (Daytime Contact): °7 v 31 v g 9 MAILING ADDRESS: C /di3i4f Ston tifDn Rd .5./ x'77 eyfo (.4 9903(, (street) (city/state) (gyp) 915 CONTRACTOR: in C CI P.Q r ii I'i eat/1 t LICENSE #: mC C� HA D (.o N N MAILING ADDRESS:7 (6o 1 E Ma. lkh n Spokgv PHONE #: 535- .69/3 919 q 19, (street) ( ty/state) (ZIP) • OR < 400,000 X 950 METHOD OF PA ❑ CASH ❑ C DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK it OF UNITS X COST EQUALS AMOUNT �1 FUEL BURNING APPLIANCE • OR < 100,000 % X 915 - /-5- 2 FUEL BURNING APPLIANCE > 100,000 X 919 - 3 UNLISTED APPLIANCE (ADDITIONAL FEE) • OR < 400,000 X 950 - 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X 9100 - 5 USED APPLIANCE (WSEC min. AFUE rating) • or < 400,000 X s50 . 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X 9100 7 BOILER/REFRIGERATION 1-100M BTU X 915 • 8 BOILER/REFRIGERATION 101- 500M BTU .X 928 . 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 . 10 BOILER/REFRIGERATION 1001 - 1,750M BTU X . 957 • 11 BOILER/REFRIGERATION +1750M BTU X 995 . 12 GAS LOG, GAS INSERT, GAS FIREPLACE — X 910 . 13 RANGE — X 910 • 14 DRYER — 1 X 910 ID 15 FUEL BURNING WATER HEATER — 1 X 910 • / T 16 MISC FUEL BURNING APPL. — X 910 V 17 GAS PIPING (ea. Outlet) — X 91 2' , 18 DUCT SYSTEMS — X $10 . 19 VENTILATING FANS — 3 X 910 ..110 20 AIR HANDLER (DOES NOT include ducting) • OR < 10,000CFM X 912 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X 919 22 EVAPORATIVE COOLERS — X 910 • 23 TYPE I HOOD — X 950 . 24 TYPE II HOOD — X 910 • I 0 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X 912 . 26 AIR CONDITIONER 3-15 TON X 920 . 27 AIR CONDITIONER 15-30 TON X 925 • 28 AIR CONDITIONER 30-50 TON X 935 • 29 AIR CONDITIONER +50 TON X 960 . 30 LPG STORAGE TANK — X 910 • 31 WOOD OR PELLET STOVE/INSERT — X 910 . 32 WOOD STOVE - FREE STANDING — X 925 . 44ENT VISA iytp SUBTOTAL: "-7 7 PLUS PROCESSING FEE: ..¢afpCr--- TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: City o f SPOKANE VALLEY Phone FAX Inspection PERMIT # BUILDING PERMIT APPLICATION 688-0036 688-0037 688-0054 / JOB LOCATION tJ. Pi ere e Box 1 OWNER � 1' CI��Sh � � ick ��u/� C� 11d � �a � � OWNER'S ADDRESS ,r /V,3/ �L 6i`c�u9/��-ori CITY //c41/7 -re) o T.G[JN PHONE n? 9/ 3/ DESCRIBE JOB 31;1/e Porn,/� ebwe/kri? THIS PROPERTY IS OWNED BY: SINGLE/MARRIED h' PARTNERSHIP CORP. BOX2 CONTRACTOR'S NAME F? ICI arca J(4.l i a» o PHONE o? 9 / 31V l' CONTRACTOR'S ADDRESS E 1431'/ 51-04,14-0•1 Kci CITY Vail e v fo r c) CONTRACTOR'S REG.# ) tar L 0 )R (o EXPIRATION DATE %/// z/0-3 (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX3 CONTACT PERSON OF PROJECT 51, e.) a J („Ji h o PHONE p?q/ aisle- 95i 8774 ADDRESS L-' l V 3/y 51-o u /?ci CITY Va. a �.1't-or d ZIP 9903‘ BOX 4 SEWER AVAILABILITY WATER AVAILABILITY� BOX 5 ESTIMATED PROJECT COST $ /go coo EXISTING BLDG. VALUATION $ BOX6 PROPERTY TAX ACCOUNT NUMBER 145114 3 . !9 I LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR 94,7 / 2ND FLOOR / 3RD FLOOR / OTHER / BASEMENT FINISHED / BASEMENT UNFINISHED 94 S / DECK I a (v / GARAGE 550 / CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING 070 FT. BOX 8 ( X) SINGLE FAMILY ( ) MULTIFAMILY (NO. OF UNITS ( ) COMMERCIAL / INDUSTRIAL ( ) TENANT IMPROVEMENT ( ) NEW CONSTRUCTION ( ) EXISTING STRUCTURE TOTAL AREA OF PROPERTY SQ. FT. IMPERVIOUS SURFACE SQ. FT. BOX 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. BOX 10 Water Service meter size (if known) Also see BOX 4 BOX 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) BOX 12 Street use may require a " Street Use Permit" for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER / AGENT DATE - I - o 3 (OVER) s-vappbp 4-16-03 I hereby authorize the City of Spokane Valley to charge the fee fox this permit to my credit card: Visa Mastercard ---- — --- ---- ---- Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. OFFICE USE ONLY - PLEASE DO NOT WRITE BELOW THIS LINE ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE 5 TYPE OF JOB: NEW RESIDENCE X RES. ADD/ALT NEW INDUSTRIAL IND. ADD/ALT NEW COMMERCIAL COMM. ALT/ADD NEW MULTIFAMILY NO. UNITS MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER OCCUPANCY TYPE OF CONSTRUCTION STORIES BUILDING SQ. FT. GI US @ L0-1,_�0 = W5;/ Lite, 4 BUILDING SQ. FT. CI GA @ ILI-(AZ = `f, 13 ,O V BUILDING SQ. FT. 1 aLe @ 15 -Cb _ 1 c(90.(50 BUILDING SQ. FT. 650 @ 6.0 = 1 o . i45-6090 TOTAL SQ. FT. TOTAL VALUATION '35"--0'2D BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES AMOUNT DUE BUILDING DEPARTMENT APPROVAL Received BY ASSIGNED ADDRESS DATE c151.75 90 35 44.e �� (elo-00 ('Iw'k) i 25s`I- leD