2004, 04-06 Permit App: BLD-04-03979 Residence AUG 03 2003 14:48 FR TO 4834%6 P.01/03
SPOlane •
doolVaLley
PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILD/NG DIVISION
11707 East Sprague Ave Ste 106
• Spokane Valley, WA 99206
Phone:(509)688-0036 Fay:(509- 003T
REQUIRED SITE INFORMATION
miimr---------J
STREET ADDRESS: E - I L17Cb CGI e ----L/
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: z---r- (y_.. ZZ Yl1 ec-/ i C-17 e'7-Si,
5T±-
PERMIT DESCRIPTION: -
� ' ING PERMIT • CICHANGE IN USE CI
GRADING GRADING C 1'W TFAc�.HOME
C P.ofaTRIN DUCAT- O TENANT DOTHER
iiimisT
OWNER / APPLICANT INFORMATION
- -milliMillOilimi
C OWNER: i aA"Z C. O0 t,_::G-LS S � :
�C-. C APPLICANT
PHONE:6-4S-3-e3-3 Z- FAX: U6S- (:)‘:, PHONE FAX:
ADDRESS: :ti - 'SIC Cresl z-m,..'€- ADDRES&
.570e/iii-e- I,.A4 c m ,STATE ZIP • CITY,STATE.ZIP
CONTRACTOR: C( 6-- Or;uC-t':4ss 'r. Q- ARCHITECT:
PHONE: 1 &5^3 Z FAX: --q----;-`-'Gi(--,C.r. PHONE FAX:
ADDRESS: /'- ' iO c!'•Ps;Gi.,-'t- 3.0Se-19A-T ADDRESS:
r
u.AA-- Creat-7 CI TY,STATE,ZIP - CITY,STATE,ZIP
WA STOOP/TRACTOR LICENSE# CONTACT:
PERMIT/BUILDING INFORMATION
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COST OF PROJECT: 30%SLOPES ON PROPERTY: ,44f) MAIN FLOOR SQ FT: I r37--
BUILDING
3ZBUILDING HE1GHTTO PEAK: 19 I OCCUPANCY GROUP:. 2ND FLOOR SQ FT: 0
BUILDING DIMENSIONS: 140V5-60 CONSTRUCTION TYPE: UNFIN BASEMENT: K32-
NUMBER OF STORIES: I STRUCTURES ON PROPERTY: FINISHED BASEMENT: Ir)
NUMBER of BEDROOMS: CRITICAL AREAS: yl..0 • GARAGE CO' •
DATE: STAFF:
METHOD OFPAYMENT, - • --
C 0 Cl rCI t1.
u.A VISA
CASH CHECK -- ' ,.
BANKCARD EXPIRES; VINO
AUTHORIZED SIGNATURE
CCan V .� 11707 East Sprague Avenue,Suite 106 v -v 509-688-0036-Phone
1J� Spokane Valley,'WA 99206 509-688-0037-Fax
Plumbing Permit Application
PROJECT PERMIT
ADDRESS: 6:-.. /I`- /CyG 6./L.,,6 /// USE:
• OWNER ---N. PHONE(DaytimeCan act):
MAILING ADDRESS:
(fit) qv. (city/state) (ZIP)
CONTRACTOR . �� = LICENSE#:
1,a� ...� (-- DC�-4SS �,Ao .
-
MAG ADDRESS: PHONE t:
i,'.<'S7O Cr ''S-7-C..-/A-e-- s CANE LA.A4- C Z1 -7
(street) (city/state) (ZIP) •
PLUMBING FIXTURES
DESCRIPTION DETAILS I OF LEWIS X COST EQUALS AMOUNT I
1 TOUTS WATER CLOSET,SIDLT5 -S X $6 - 15;
2 URINALS X $6 -
3 TEJHS 3 x $6 - I \
4 SHOWERS(PER TRAP) ,HATFLSrALL,ON-SITE BUILT T X 56 -
5 SINKS LAVS/6A54VS,BAR,FLOOR,KITCHEN,
CHEN,
LAUNDRY,UTILITY,JAMTOR,PHOTO,X• X $6 - \.g
RAY,FOOD.PRP3KUI IIdARY/MSAT
6 DISHWASHER ( X 4 $6 - (o
7 CLOTHES WASHER 1 X S6 -
6 GARBAGE DISPOSAL 1 X $6 (v
9~WATERSOFTENER X $6 ,
10 SLSCf.PHOT WATER TANK NOTE:LE GAS,SEE MECHANICAL X $6 -
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE 1 X s6 -
12 FOUNTAINS.DRINKING X $6 •
13 WATER PlPING/DRAIN•IN INSTALLATION,ALTERATION,REPAIR,
WASTE,VENT PLUMBING REVERSALS X $6 -
REVERSAL
14 SEWAGE EJECTOR GRINDER,SUMP PUMP X 56 -
15 WATER USING DEVICE ICS AND/OR Wet.IA MAKER,HOSE BIB,
STEAMER.PROOFER,CARBONATOR. X $6
SWAMCOOLER ,..-33 1
_
16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND
R.P.B.PD.FOR:VATS,TANKS,,$OILERS X -
17 SP1UN LER SYSTEM 1 X $25 •
18 INTERCEPTORS ' GREASE TRAP,SAND TRAP,CHEMICAL
HOLDINGTANE X
19 MEDICAL GAS per cutlet NITROUS,OXYGEN X $6 - 1
?D MSC.PLUMB/NG FIXTURE X $6 -
SUBTOTAL:CBTHOD OP•PAYAENTamp _
PLUS PROCESSING FEE $35.00
3 C.4SFH ❑ CHECK 0 0 . .
•
TOTAL PERMIT FEE DUEi$ 3
ATR EXPIRES:
ANKCARD NUMBER
UTHORJZE1a SIGNATURE:
** TOTAL PAGE.133 **
HUI.] 'ES 617103 14.4d rk I U 41=134bb r.eier u..2
�` 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
SOSpokane Valley,WA 99206 509-688-0037-Fax
•Mechanical Permit Application
PROJECT PERMIT
ADDRESS: _ l L17Q(& cel/- USE
OWNERL4A;7t 6- Do r-A.C. PHONE(Daye Contact):
MAILING ADDRESS:
ti , s s-tO es i f t,,€ s.,,r A. - (AAA - c Z/7
(street) (city/state) (RP)
CONTRACTOR:LA,A) c G_ c U C-e_ASS A,•C, LICENSE I2
MAILING ADDRESS:. PHONE
Gss 3--C�S`32-
/l., 'sic c;es-7e-(n-e. s ; ....4.,-E-: LL,A. 4 wiz i 7
(street) (may/state) (ZIP)
DESCRIPTION OF WORK ,t OFLIIVITSI I 1 COST EQUALS i AMOCAT
1 FUEL BURNING APPLIANCE .OR 4103,000 ( I X SIS - - ( .
2 FUEL Bt32NINC AM-2mm >100,000 X 519 •
3 ANLSTED APPLIANCE(ADDITIONAL FEE) -,OR a 400.000 X 111 7
$5o -
t UNLISTED APPLIANCE(ADDlIIQNAL FEB) >400.030 X5100 .
5 LED APPLIANCE(WSECmkt AF(IEnin) .are 400.000 X { 490 -
6 USED APPLIANCE(WEECFNA AFT/E ming) >405,000 X 5100 •
7 BOILELUREFRIGFRA3ION 1-10024 BTU X 515
B BOILEIVREFRICERATION 101.500MBTU X 523 .
9 {BOILER/RPFRIGc'RA71ONr 501.vow BTU j X 539 -
10 BOILER/REEBTCERATRON 1001-1.75024 BTU X . S37 •
It BOIL6R/SE5R10ERATION .175).(BTU X RS —
12 GAS LOC,CAS INSERT.GASFIREPLACE - 1 X S10 • iC%
u RANGE - x 510 -
14 DRYER - r X 570 - • -
25 FUEL BURNING WATER HEATER - / } X 510 - IV
16 MSC FUEL BURNING APP(. - X n0
17 CAS PILING(ea.Qutle1) - 3 X SI -
18 DUCTSISIEM9 - / X s10
19 VENTILATII4GFANS - 4- X au • I 44i7
2D Adt HANDLER(DOES NOT 111614 dosing) -OR a 10.000CFM X S12 -
21 AIR HANDLER(DOES NOT Include gilding) >10=CM X 519
22 EVAPORATIVE COOLERS - X 510 •
23 rrTYPEIHOOD - X 550
24 'IYPE11HOOD - X 510 {
25-HEAT PUNLWAIRCONDI'IIONER 03 TON .� X 512 - It
25 AIR CONDIT/ONa, 1x15 TON X S7J1 - I
27,AIR CONDCt7ONER 15-32 TON X 52S • J
38 AIRCONDTDONER 30.50 TON X 535 -
29 AIR COND117ONER +52 TON X S60 -
30 LPC 57'ORAGETANX - X 510
32 WOOD OR PELLETSToveANISERT - X ' 510
3Z WOOD STOVE-FREESTANDING - X 525 -
I
St1ETOTAL1 S —
MEL•I3OD OF PAYMENT PLUS PROCESSING FM 535.00
iiiiiii401-
TOTAL PERMIT PEE DLII: i 7�jI2CASH ❑ CHEG�C ❑ ❑
DATE: EXPO&
BANKCARD NU ER
AUTHORIZED SIGNATURE
//
Lanzce G..Dougl _Inc- 81 E: Rosewood Ave., Spokane WA 99208-“0;
House PIan_ Address: .d47C‘ GFS--ec-'—
Bedrooms: Le��aI: LOT ,z.-z_
BLOCK ,
Development_ s� n�-e,^ i c rD �o,s; �'
Elevation:
Scale: I"=70'
C, ikSL-Q-Ai L._., . 1,) At
e6s,
_ ,
. _ _
This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
C
representation of the proposal All known property
linesldimensions.,curb lines,structures and easements
have bee• identified. Also in• -ated are.wetlands.
bodi�r/ to t -�s -• • other cr. -1 areas.
Si,f' ,• / 1
Date:
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