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
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