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2003, 07-25 Permit App: BD-03-842 Residencegliolian°1e lley • \;)) A,01 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206.... Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: I 2,0 O ai i j t�.iC ASSESSOR'S TAX PARCEL NUMBER(S): 3 5 al 3. Q 70/ LEGAL DISCRIPTION: L T 1 S I / r- R e y / VD I :,0, 4 PERMIT DESCRIPTION: gilITILDING PERMIT RELOCATION Q � . • U CHANGE IN .USE 0-SIIGN• D GRADING ®-TENANT .E1MANUFACTURED .HOME O-OIHER.. • OWNER / APPLICANT INFORMATION /I OWNER: Rb 6 e r)t4} ,) _ Asi. APPLICANT: 7d bl'`'/ c PHONE: 6.0 - $ 3$ P /'a /FAX: PHONE: I' b .34` fig b % FAX: g 3f -a .'60 ADDRESS: O., i til P c (4e nL' y I,J4 , ADDRESS: (j t) " n / ( 44.1/ CITY, STATE, IP fikONTRACTOR: PHONE: FAX: ADDRESS: CITY,. STATE, ZIP CITY,STATE, ZIP ly WA ST CONTRACTOR LICENSE # itaf 1! ARCHITECT: PHONE: ADDRESS: le e-iap FAX: CITY, STATE, ZIP CONTACT: PERMIT/BUILDING INFORMATION ' 0 COST OF PROJECT: q � t!,D(,/30% SLOPES ON PROPERTY: /1 D BUILDING HEIGHT TO PEAK: a f BUILDING DIMENSIONS: 02 7X Lf It 'NUMBER OF STORIES: o� NUMBER of BEDROOMS: FLANKING SETBACK: OCCUPANCY GROUP:. Wadi CONSTRUCTION TYPE: STRUCTURES ON PROPERTY: 69 Ke_ CRITICAL AREAS: CURRENT PROPERTY SIZE: FRONT SETBACK: 1-/ / CURRENT PROPERTY USE: I4t 6604- 4 REAR SETBACK: 3 CURRENT SEPTIC USE: ;po l , (' Se Jam(' LEFT SETBACK: l 0 CURRENT WELL USE:40 81:C L2 RIGHT SETBACK: 1-) ,to e IMPERVIOUS SURFACE AREA: o F ASpc,tv)i MAIN FLOOR SQ FT: / 2. 2ND FLOOR SQ FT:. UNFIN BASEMENT: FINISHED BASEMENT: GARAGE:6f. 7 COVERED DECK: AO DECK: y�s USS-5SL-12, Spokane Valley, WA 99206.... Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITEIIt9FORMATtON STREET ADDRESS: LO' 0 .S Per-Q ASSESSOR'S TAX PARCEL NUMBER(S): LI 5 a 13 70/ LEGAL DISCRIPTION: ('. 73 - PERMIT DESCRIPTION: - ING.PERMIT $��IIANGE.IN USE a. Rr a r RELOCATION • 111 ®-SIGN• -TENANT a MANUFACTURED HOME O -OTHER- OWNER / APPLICANT INFORMATION OWNER: RCA F r/)1UC A) t/ L PHONE: �Oq - $ 3 ay p `/eb /FAX: c r%%?ne/� vi ,ADDRESS: (,�'.ADDRESS: p CJ W Gr, 41 L% CITY,STATE, ZIP gq CITY, STATE, IP fikdNTRACTOR: . . ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,. STATE, ZIP j2 APPLICANT: P6 b171 ,+ / •V%%� t-C—AA PHONE: Se 7' �.34' 4 6 % FAX: $ $ -0 `6q0 tyre CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # CONTACT: BUILDINGS: Tz` APPROVALS PLANNING: ILA 4 , -7- 0-3 ENGINEERS: HE H: SEWER. SPS ,r- 06-1,1 rt � lt^�„ i �,1.� i/aA,k4 4..g. 7 -aci -0 FIRE D i7F z 6 7 3 6 LI 9 S~' X . /4.(.6 7 3(.. y /9 • o iD'eK /5 0 Oaf -6 "7,22-7 © 0 9 556.00 5o. oc9 /05/ /V,27 // crrt t !� �11� ►*pU am ,0,0Valley 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: 6 015 h r rL� PERMIT USE: OWNER X PHONE (Daytime Contact): MAILING ADDRESS: AMOUNT 1 (street) (city/state) (ZIP) CONTRACTOR: $15 LICENSE #: ! c"1 MAILING ADDRESS: FUEL BURNING APPLIANCE PHONE #: f X $19 (street) (city/state) (ZIP) /10 9e- ei4eeS METHOD OF PA ❑CASH El DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK It OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE - OR < 100,000 X $15 - ! c"1 2 FUEL BURNING APPLIANCE > 100,000 f X $19 - 3 UNLISTED APPLIANCE (ADDITIONAL FEE) = OR <400,000 X $50 - 4 UNLISTED APPLIANCE (ADD211ONAL FEE) > 400,000 X 8100 = 5 USED APPLIANCE (WSEC min. AFUE rating) - or <400,000 X $50 = 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X $100 = 7 BOILER/REFRIGERATION 1 - 100M BTU X $15 - 8 BOILER/REFRIGERATION 101- 500M BTU X $28 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $39 - 10 BOILER/REFRIGERATION 1001 - 1,750M BTU X $57 - 11 BOILER/REFRIGERATION +1750M BTU X $95 - 12 GAS LOG, GAS INSERT, GAS FIREPLACE - X $10 = 13 RANGE - X $10 - 14 DRYER - X $10 = 15 FUEL BURNING WATER HEATER - ( X $10 - / 0 16 MISC FUEL BURNING APPL. - X $10 - 17 GAS PIPING (ea. Outlet) -ita X 81 - 2 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - X $10 L,/ 0 20 AIR HANDLER (DOES NOT include ducting) - OR < 10,000CFM 1 X $12 - 21 AIR HANDLER (DOES NOT indude ducting) > 10,000 CFM X $19 - 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 - 24 TYPE II HOOD - X $10 - 25 HEAT PUMP/AIR CONDITIONER 0-3 TON l X $12 - /‘' 26 AIR CONDmONER 3-15 TON X $20 - 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 3050 TON X $35 - 29 AIR CONDITIONER +50 TON X $60 - 30 LPG STORAGE TANK - X $10 = 31 WOOD OR PELLET STOVE/INSERT - X $10 - 32 WOOD STOVE - FREE STANDING - X $25 - 4IENT VISA' ;4e.:51J7Lf SUBTOTAL: 7 PLUS PROCESSING FEE: X45 (10 , TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: [ETHOD 0 ] CASH ,ATE: Sticrito' c� alle „00►0Valley 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: ! ., 6 � �., P `: f c r DESCRIPTION PERMIT USE: OWNER: pix.r/ ,ivi c to -- X PHONE (Daytime Contact): MAILING ADDRESS: v✓ Ii its/i Fe .y /4 _ Flo (street) (city/state) (ZJP) CO 9R: / C ` / fib h Lf%f' ` LS AS,r fi Cif LICENSEvG sit ? L #: / ✓ 9.r ''ri e !' p C3 9 MAILING ADDRESS: Ct) - <; 611 cAJW,t)te, fleAzey, LAIR- RS. PHONE #: 3 S. - 1 Ki 0 iqf69 (street) (city/state) (Lll-') ' PLUMBING FIXTURES ANKCARD NUMBER: UTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS ? X $6 - J 3 2 URINALS X $6 - 3 TUBS 'r>� X $6 - / 2 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT / X $6 - 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 21 X $6 - y 6 DISHWASHER / X $6 - 6 7 CLOTHES WASHER I X $6 - G 8 GARBAGE DISPOSAL / X - 9 WATER SOFTENER () X $6 - 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL pr/,(� X $6 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6 12 FOUNTAINS, DRINKING n X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP 75 X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS 1 X $6 - 17 SPRINKLER SYSTEM eD vk. ' /A G A / C) X $25 - 18 INTERCEPTORS GREASE TRAP, MND TRAP, CHEMICAL HOLDING TANK X $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN 0 $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK MOM 41%51 ... .-., _``. SUBTOTAL: C7 D PLUS PROCESSING FEE —$el€430 '" ■ iiiiiiiii • TOTAL PERMIT FEE DUE: ANKCARD NUMBER: UTHORIZED SIGNATURE: r -TP 1 - APPROVED BY (qo' 0-1 TO ai ASPti4..14 p <� Vl 0 z ni D 33 0 0 33 :Aa 03A0klddV 0 m m cn 0II 0 0 0m O z zz Om fp 0 O 0 n m c) 0 c c --4 r m CO v m v m NORTH ARROW 9 D 3 f9 /ERC E Ri L 44,2: 2' NOTE: WHERE POSSIBLE MAKE TIES TO TOPO SHOWN ON DRAWING PROJECT NAME: A f �L g VA L L E Y REF. DRAWING NO. /I/25- FILE I/2s FILE NUMBER: U' 984 PARCEL: 45213— 070/ STREET: P, E i C g , ADDRESS: VA c,4 N T 01 CONTRACTOR 3L)1aNsczs1J INSPECTO { L% "' COMPANY SPo/(as.)E- d0uAiry DATE WSTALLED 7/7/�S STUB: DIA. 4i‘‘ TYPE AS - LENGTH 3 CENTERLINE STATION -3+"'slimr LINE NO. ; P STA. OF AND DIRECTION TO NEAREST MANHOLE 3-147.6 14ewok INVERT EL. 2.0 4-1 .7. 8 DEPTH FROM NATURAL GROUND TO STUB 1C:11. tom LOCAL B.M. ELEV. Z.n58 . Ab DESCRIPTION OF LOCAL B.M. Stv_ N "V'en.+...E . C. PIPE GRADE: 4- ."1 �0 /0• FT. BELOW THRESHOLD HOUSE TYPE: Vote -AI. r'.._c REMARKS 06/.26./200.3 THU 9:10 FAX 509 926 159 Transnation Title 1J005/008 • FINAL PLAT OF FREY ADDITION SPOKANE COUNTY, WASHINGTON IN SW Via, SEC. 21, T.25 N,R.44 E.W,M. OCTOBER,1955 — SCALE: I"=100' Scale Reduced to 1" = 150'' C.V. PAY N6 Registered. Land Surveyor Spokane , Washington !326.74' .5"WATER MAIN 121.68' a^ 4111 1141 tiltm 141.7'0' 11141 sag 6 io ict 1 NE} a 1 O4 AdP. 4 3 141. L 140.0' 2 '2o ' S29'38'W:3ti.72' 1I. AVENUE Spokane County Division of Utilities SEWER CONNECTION PERMIT APPLICATION FORM (( J PLEASE NOTE: This application form must be filled out accurately and in its entirety, and signed, or a permit will not be issued. Also note that sewer permits are valid for 12 months form the date of issuance. No extensions will be granted. A separate right-of-way permit is required for any work performed in or from the county right-of-way. PROJECT INFORMATION Job Address: r� / Parcel Number: 5 oZ < 3 ` O 7O Lot: Block: Project Name: ULID Name: CHECK APPLICABLE BOXES ❑ Regular ❑ Dry Sewer ❑ Repair O Addition ❑ Abandonment ,' Residential O Commercial O Temporary O New O New Owner's name: b Address: �; O b 1 / City/State: Zip: Phone: s q ` � 3'95 / * FIRST TIME CONTRACTORS OR HOME OWNERS PERFORMING THE INSTALLATION MUST FIRST CONTACT THE UTILITIES DIVISION BEFORE PERMIT(S) CAN BE ISSUED. SIGNATURE OF UTILITIES DIVISION PERSON CONTACTED: ��orf rriU& name):�C� S ` t,C?�Ptn°41 I �1 Business address: SW/ 1 / (,(J%t4e , - Citc/State: e - e. (A) if Zip: qq. e -i Sate const c or cense number: A/0 -1-11. Pio 3�c�j Contact NiLineii 1/14 cid crtf— Phone Number: 60 d — INTERIOR PLUMBING ALTERATIONS? (ye Fr// out the information in the table below if applicable Contractor (if different from above): ` Phone: Business Address: rcle one City/State/Zip **For plumbing reversal fee information, see reverse side of this form. I FEE INFORMATION Number of Buildings connecting to sewer l X (times) 5100 (per bldg) = S + S10.00 = • l or n single -Family residential unit, one permit is required; • • For a condominium, townhouse, duplex, triplex or fourplex with separate ownership (as determined by lot lines) separate address and .separate stub, one permit is required per address per stub: For a single building duplex, triplex or fourplex with single ownership, one permit is required • Multiple buildings (apartments, industrial complexes) with single ownership, one permit required per building connecting to the sewer. 111(;11-r OP 55'.11' PhR\IIT (FOR SITUATIONS NOT COVERED HERE, CALL THE COUNTY DIVISION OF UTILITIES AT 477-3604) Is any of the work to be performe APPLICANT SIGNATURE: Method of Payment: 0 Cash fro /the county right-of-way? O Yes Xi No 4494--. DATE: 7-/5-0_3 yet Check 0 Visa 0 MasterCard ❑ Discover Card Date: Expires: Bankcard Number: Authorized Signature: Spokane County Division of Building & Code F.Inforecmcnt 11126 West Broadway Avenue * Spokane W;\ 992(' Tel. No. (5091 477-3675' Fax No. (5091 477-71911 *TDD No. (5091 477-7133