2004, 04-26 Permit App: BLD-04-04190 Residence AUG 03 2003 14:48 FR TO 4834966 P.01/03
}
/O sr/ r°1--
*awe •
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 88-0037
(REQUIRED SITE.INFORMATION
STREET ADDRESS: �- /14 51(e, a
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: Zt 2 T31 `ZZ- - .. .}4 'l6Trel L O 7 4140
PERMIT DESCRIPTION;
CIELTILDING PERMIT - C CHANGE IN VSE ®JGRADING C MAN PACIVRED HOME
CREEOCAnON E2 SIGN DTE AIN'T MOTH
1 OWNER/APPLICANT INFORMATION 4111101401=
0 OWNER: .44/V7C6: 6. DocX-14s.s a-A/c. ® APPLICANT:
•
RHONE:4-I83--&s32 FAX: c.-ISS-6-19 6C .PHONE: FAX:
ADDRESS: ,1 'S7Q C(€si ADDRESS
t,,v1A E1 l,STATE,ZIP • • CITY,STATE.ZIP
13
44/
CONTRACTOR: JZ Z Cr_ 'Do L3CA-sQ.S 1' ARCHITECT:
PHONE: X19 -0S-3 Z FAX: 3-(-496,C, PHONE: FAX
ADDRESS: it). 51c) PGS[�;� Spp ADDRESS:
WA- O(cr7_ CITY,-STATE,ZIP — CITY,STATE,ZIP
. WA ST CONTRACTOR LICENSE# L 66A)"ZC 6-00-1 1 PS CONTACT:
PERMIT/BUILDING INFORMATION Ammagri
COST OF PROJECT: 30%SLOPES ON PROPERTY: -4.---ED MAIN FLOOR SQ FT: /05.-
BUILDING HEIGHT TO PEAK: ZO OCCUPANCY GROUP:. 2ND FLOOR SQ FT: 0
BUILDING DIMENSIONS: 5-.5X S'Z• CONSTRUCTION TYPE: UNFIN BASEMENT: /c6-C)
NUMBER OF STORIES: STRUCTURES ON PROPERTY: FINISHED BASEMENT:, , d
NUMBER of BEDROOMS: '1 CRITICAL AREAS: GARAGE: -77 Z .
DATE: 6.STAFF: .._
METHOD OF PAYMENT: _. •
GASH CHECK •
BANKC4RD,f' EXPIRES; VIN#
AUTHOR/PED SIGNATURE:
HUU 03 2003 14:4U FR TO 41i4ybb t'•ueie-1
����,,;; ��4�.„',�` 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
UlJQl�t,L�.!!C Spokane Valley,WA 99206 509-688-0037-Fax
—Mechanical Perrrimit Application
PROJECT / ' PEPERMIT
-
ADDRESS: L�,', to sj 1/d &U '�/ `i/ USE
'
OWNER:L4A.;24: — Ci- Do .,-CASs m--„..c,. PHONE(Daytime Contact):
MAILING ADDRESS:
Ai . S3 S IG C res— -i A,€- 5 x /t tA.v4 - Z!7
(sem) (dty/state) (ZIP)
CONTRACTOR
MAILING ADDRESS:. PHONE
ass 3--C�5r32-
/(f- 3140 c; 5; -I&€— .5 ,�A-E t4. Cr I
(street) (City/state) (ZIP)
DESCRIPTION OF WORK ,107 UNITS I % HOST EQUALS I AMOUNT
I FUEL BURNING APPLIANCE •OR<100A0O I i X $23 - 1 , 5
Fun FVBURNING A!'UzAN >100.000 X 519 •
3 UNLSI D APPLIANCE(ADDIIIONAL FEE) -OR<IOO.00O I X 550 -
4 UNLIT EA APPLIANCE(ADDi IONAL MEI >400.000 X I Sim -
ni..
5 UEDAPPLIANCE(WSEC AFUEsath�g) .ar<40Q.000 X 930 -
6 USED AP?UIWCF(WSECnun.ARM rating)' >400,X0 t, X 5100 -
7 BOILER/REFRIGERATION 1-1001(BTU X S1S •
0 BOILER/REFRIGERATION 101.12 RV x 52e -
9 BOII.IIVRBFRIG'2RATION ` 501-1.000M ETU X 539 -
10 BOA_ER/PEFRIGSRAT1ON 1001-1.750x(MU X S37 •
_
12 BOILER/I5 CERATION .17506 STU X $95 -
u CAS LOC.CAS INS=GAS FIREPLACE - I X 510 • r(J
>3 RANGE - x no -
14 DRYER - X 510 •
15 FUEL.BURNING WATER HEATER - / X $10 - I IC)
26 NBC.FUEL BUR UNG APP(. - X 520 -
17 CAS PIPING(ea.Duda) - 3 x s1 _ ,
I8 DUCTSYSTEM9 _ - / X 510 i t 0
•
19 VENTILATONGFANS - L X SID - 4.40 t
20 AtiLHANDLER MOM NOT 1ncard.daces) -CSB<10ADCi7d X $12 -
21 AIR HANDLER(DOES N(7C Mud*chiding) >10.000 CM X $19 -
22 EVAPORAIIYEcooLERS - X 510 -
23 TYPE IHOOD - X SRI -
24 TYPE II HOOD .. X 510 -
25 NEAT PUMP/AIROONDIIIONER 03 TON X 512 -
25 AIR CONDITIONER 34S TON X , 570 - _ I
27 AIR CONOMONER 15-30 TON X Sts - 1
28 AIRCONDCONER 30.50 TON X 535 -
29 AIR CONonsoNER +SO TON X 560 -
30 LPC STORAGE TANK �• - X 510 -
II WOOD OR PELLETSIOWANSERT - X ' 510 -
32 WOOD AVE-FREESTANDING - X 525 -
SUSI.OTAL: c c3 -" .
METHOD OF PAYMENT PLUS P'ROC85SIING FEE 535.00
NMI 6vim0...._, TOTAL PER IIT FEE DUE: i Z j`-
❑ CASH ❑ CHECK ❑ ❑
DATE EXPIRES:
BANKCARD NUMBER:
AUTMORIZEL7 SIGNATURE:
Iri• ��Sffoiiane 11707 East Sprague Avenue,Suite 106
509-688-0036-Phone
Spokane`Palley,WA 99206 509-688-0037-Fax
-Plumbing Permit Application
PROJECT PERMIT
ADDRESS: e, j c f 5 l cv Qi,/ USE
OWNER: --� PHONE(Daytime Contact):
MAILING ADDRES&
(street) `, (city/state) (ZIP)
`CONTRACTOR . LICENSE 4:
- i-Q�ZG C:-- DC -G-G4S S .-L-,A .
MAILING ADDRESS: PHONE t:
-
AL- SI0 Cr :s �vue- s4C/9n.E w4- C• Z! 7
(street) (city/state) (ZIP) '
•
PLUMBING FIXTURES
DESCRIPTION DETAILS l;OFUZVITS X I COST EQUALS AMOUNT
I TOILETS WATER CLOSET,3I)ETS - X $6 - 1C;
2 URINALS X $6 •
s RUBS 3 _ x $6 _ - 1 S
4 SHOWERS(PER TRAP) ._BATSTALL,ON-5FIEBUILT X 56 -
5 SINK LAVS/BASINS,BAR.FLOOR$CITCHEN,
LAUNDRY,UTILITY,JANITOR,PHOTO,X- 3 X $6 -
_ RAY,FOOD,PREPK.'UL U4ARY/MSAT
6 DISHWASHER I X $6 - (v
7 CLOTHES WASHER _ 1 X $6 - C,
8 GARBAGE DISPOSAL I X $6
•
9 WATER SOFTENER X 56 -
10 ELECT.HOT WATER TANK NOTE:W GAS.SEE MECHANICAL X S6 -
11 FLOOR DRAINS AREA.CASE,COI,naiad.coNDENSATR i X $6 -
12 FOUNTAINS,DRINKING X $6 •
13 WATERPIPINGIDRAINjN INSTALLATION,ALTERATION,REPAIR,
WASTE,VL+NT,PLUMBING REVERSALS X $6 -
REVERSAL
14 SEWAGE EJECTOR GRINDER SUMP PUMP X $6 •
15 WATER USING DEVICE IC&AND/OR ?QE .MAIM,HOSE BID,
STEAMER.PROOFER CARHONATOR. X 66
SWAMP COOLER ,3 1
I6 CROSS CONNECTION DEVICE VACUUM BREAM,CHECK VALVE AND
_ R,P.B.PD.FOR:VASS,TANKS.BOILERS X -
17 ,SPRINKLER SYSTEM I X $25 •
18 INTERCEMRS ' GREASE TRAP,SAND TRAP,CHEMICAL
HOLDING TANK X -
19 MEDICAL GAS per outlet NSROUS,OXYGEN X $6 - 1
20 MISC.PLUMBING FJX URE X $6 -
SUBTOTAL
=HOD OP•PATMENT _
PLUS PROCESSING FEE: $35.00
] CASH ❑ CHECK 0 0 MI
TOTAL PERMIT FEE DUE: 3 ,
ATE: WIRE&
ANKCABD NUMBER
UTMORIZ.ED SIGNATURE:
** TOTAL PAGE.03 **
Laazce G_.Doueons.Inc 815 E. Rosewood Ave_, Spokane WA 99208-5507
House Plan: Address:
Bedrooms: Leeal: LOT `Z BLOCK ZZ
Baths: Devetopmenr.Sc; moi-- ,c �� --
Elevarion: Scale: 1"— r s�
•
N
i0,b '
tiLX
•
ig\s /
33'
e
l�
I wl I 'AA
2z
161.
This site plan is being submitted for theur
ose of
obtaining a building permit and Is a true and p
//4-4/ representation of the
property
lines/dimensions,curb lines, All
known easements
have been identified. Also Indicated am
Hands,
bodies of water, steep slopes or
other critical areas.
Signed:
Date:
ADDRESS J51' C -' -+1- i(
ZONE
ROAD WIDTH 16
FRONT .'3io` FLANKING
COMMENTS
REVIEWED 8177:11H1-1-1-41""lJ'1b4":