2004, 06-01 Permit App: BLD-04-04476 DuplexSpokane
Watley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
NEW SINGLE FAMILY RESIDENTIAL
Job Address: 520 N RAYMOND RD
SPOKANE WA 99206-3893
Description: NEW DUPLEX W/ATTACHED GARAGES - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
SEVERSON, ALVIN
SEVERSON, ALVIN
PO BOX 141735
SPOKANE VALLEY, WA 99214
Application #: BLD -04-04476
Applied:
Issued:
Expires:
Lot: Blk: Parcel No: 45174.0802
Phone: (509) 999-6080
Phone:
Lic No:
Zoning:
06/01/2004
11/28/2004
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SINKS
DISHWASHER
CLOTHES WASHER
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
dup
194296
15
70 X 54
1
6
35
29.25
21
5
r-3
5-n
1
96X118
no
no
4
4
6
2
2
4
2
2
2
4
6
2
Fees:
PLAN CHECK FEE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SINKS
DISHWASHER
CLOTHES WASHER
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
610.30
20.00
20.00
4.00
60.00
1,525.75
4.50
24.00
24.00
36.00
12.00
12.00
24.00
30.00
Total Calculated: 2,406.55
Deposits/Receipts: 0.00
Total Due:
2,4Q6.55
9.0
CITY OF SPOKANE VALLEY i - 6
s 61,55
APPROVED FOR SUBMITTAL
Initials / Date RE/IEWED FOR CODE COMPLIAN
SPOKANE VALLEY BUILDINQ DIVISIO
06/4;2/*/ _
Building
Planning
Public Works
.,-AA-z-A 01- 3(0i -N ad-ua
THIS IS NOT A RECEIPT
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
5-20 3---a-? 67,),-\et-vcit
Assessor's Tax Parcel Num er(s): q5-7 '7 / o5c 2 / 7L
Legal Description:
PERMIT DESCRIPTION:
Building Permit
(
❑ Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: Se4 7eir "
Phone: &)9Q Fax:
Address: 7,00State "Zip Code
❑ Contractor:
Phone:
Address:
SACc_
City
State Zip Code
WA State Contractor License #:
❑ Applicant:
Phone:
Address:
Fax:
City
State
Zip Code
❑ Architect:
Phone:
Fax:
Address:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: /
DIMENSIONS: _ /
O
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"" FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
L
FINISHED BASEMENTS FTG:
GARAGE SQ. FTG:2 ,�
y
DECK/COV. PATIO SQ. FTG.,
�
(
OCCUPANCY GROUP:
CONSTRUCT N TYPE:
/ 90101 F"�.y Q
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE. SPACE:
�3
IMPERVIOUS SU ACE AREA:
�,ffi_
COST OF PROJECT:
1121'a,
30% SLOPES ON P OPERTY;
_i_al
SEWER OR O - E TIC
SYSTEM? Se Spy
1
1
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year:
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
I nspector(s):
Fax:
❑ WELDING
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a
dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the
property owner. 3) The signatory is the property owner or has permission to represent the property owner in this
transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code.
Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley
Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check 0 Mastercard ❑ .VISA 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature:
Project Addr-ss:
Owner:
Mailing Address:
Contractor:
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
$.
4.4'), / ) ten• A J
City
i,Qri f License #: Phone #:
1� a-• State
Mailing Address:
Permit Use:
e (Daytime Contact):
State
c
ip Code
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
$19.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100.00
=
5
USED APPLIANCE (WSEC min, AFUE
rating)
Equal to or less than 400,000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - SOOM BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
X
$10.00
=
14
DRYER
X
$10.00
=
15
FUEL BURNING WATER HEATER
2
x
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.0Q
=
17
GAS PIPING (each outlet)
/f
p
X
$1.00
=
18
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
[.i
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or Tess than 10,000 CFM
,
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10 000 CFM
X
$19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X
$25.00
=
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
METHOD OF PAYMENT:
D CASH 0 CHECK IDVISA 0 MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
TIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
Zip Code
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildngDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
State Zip Code
Contractor: License #: Phone #:
City
Mailing Address:
Zip Code
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF
UNITS ,
X
COST
a
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
56.00
=
3
TUBS
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
X
56.00
=
PREP/CULINARY/MEAT
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
56.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR:
VATS, TANKS, BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
58.00
=
METHOD OF PAYMENT:
Q CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
z
► •
,s
6 5
Ingress/Egress/Sewe
& Utility Easement
10' Utility Ease e
4
Emergency Apparatus
Turnaround &
Road Frontage requien
'E
311.46
0
20'
LOT "u
7,208 S
118.46
ry
0
80'
LOT „C„
0 11,384 Sq. Ft.
OD
N
O
cn0
0
0 75.
N89'30'55'E
Building Setback
rder Easement
0
118.46 /►d
311.46
5o/;ate 0
Raymad
�-. .
20'
0 25 50 100
03A0dddt/ 1d30 DNINNIfl
ScDL
4 J , Qay rir
ti
Raymond
,\\
LOT "A" OF SP -22-03
Founded 1946
®impson Engineers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARG❑NNE ROAD, SPOKANE WA, 99212-2789
PHONE (509) 926-1322 FAX (509) 926-1323
P
\ Pro jects\14501-15000\14626-SEVERS❑N\dwg\SEVERS❑N.dwg 05/17/2004 02:06:28 PM PDT