2010, 09-14 Permit App: 10002887 Residentialcm of � v
11703 E Sprague Ave, Suite B-3 PERMIT NUMBER:/6-) L
Spokane Spokane Valley, WA 99206 PERMIT FEE:
jValley- (509)688-0036 FAX: (509)688-0037
www.Wokanevallev.org
Community Development
Residential Construction ® New Construction ❑ Accessory Bldg
Permit Application ❑ Addition/Remodel ❑ Deck
F-1 Other:
SITE ADDRESS:
ASSESSORS PARCEL NO: 40'; L4_I • I S0G:> LEGAL DESCRIPTION: S4f0---:Cq M tpr t0
Building Owner:
DIMENSIONS:.
S(o/ )(- Ll4�; ( 011
Name: \i s
�C
Lla '
Address: O y I
2 FLOOR SQ. FTG:
City: 1 1
State Zip
Phorb, Sa , s - l `
ax: CX r
Contact Person
Name:
Phone:
Describe the scope of work in detail:
l
ago e,
Proposed Use: 5
Contractor:
DIMENSIONS:.
S(o/ )(- Ll4�; ( 011
# OF STORIES:
Name: r S
MAIN FLOOR TO SQ.
2 FLOOR SQ. FTG:
Address: ( ,
IMPERVIOUS SURFACE
City: S' V.(
��
State: Zi ad�
Phone: �
Contra&r • )`10
S s
E,xp Date: e?/ -3,/(,
City Business Liic. No:
��
.► c) as N�
Cost of Project: $ � F F, OrC�0-0
**************The followinc MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:1
��
DIMENSIONS:.
S(o/ )(- Ll4�; ( 011
# OF STORIES:
TOTAL HABITABLE SPACE:
MAIN FLOOR TO SQ.
2 FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
FTG:'IS'�
22
��
_lq"
AREA:
FINISHED BASEMENT
GARAGE SQ. FTG:
DEC COV. PATIO SQ. FTG:
30% SLOPES ON
SQ. FTG: �
C'> ..- &((P
�
PROPERTY:
# OF BEDROOMS:
CONSTRUCTION TYPE:
HEAT SOLTIR E:
SEWER OR SEPTIC?
A fm
The permitee verifies, acknowledges agrees their gnaturethat: 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE: DATE: �` 0
Method of Payment:
❑ Cash Check
Bankcard #:
❑ Mastercard ❑ VISA
Expires: VIN#:
Authorized Signature: �
REVISED 2/15/07}
�1
RESIDENTIAL CHECK LIST DIRECTIONS:
Place a check mark in box next to each document required for complete submittal.
❑ SITE PLAN
❑ Property lines and dimensions ❑ Setbacks to property lines
❑ Direction arrow pointing North and orientation to streets ❑ Distance between buildings
❑ Proposed/existing buildings (footprint and dimensions) ❑ Right of way/easement location & sizes
❑ Utilities, septic tank/drain field locations and distances ❑ Driveway approach size and location
BUILDING PLANS (3 SETS) (minimum 1/8 inch scale or completely dimensioned)
❑ Elevations (Front/Rear/Sides) with roof peak and wall height including basement:
❑ Foundation Plan (crawlspace, basement or slab on grade):
❑ Footing sizes and locations ❑ Supporting wood cripple walls or beams
❑ Perimeter concrete foundation wall sizes ❑ Thickened concrete pads supporting
❑ Crawlspace ventilation beams or girder trusses
❑ Floor Plan of each level (finished or unfinished) with dimensions:
❑ Floor Joist direction, size and spacing ❑ Window and door location and sizes
❑ Header, beam or concrete lintel sizes ❑ Window well locations if applicable
❑ Brace wall panel locations ❑ Room usage labels
❑ Water heater and furnace locations ❑ Smoke detector locations
❑ Exhaust fan locations ❑ Attic and crawl space access locations
❑ Deck or concrete patio sizes and locations ❑ Fire Wall construction
❑ Roof Plan:
❑ Engineered truss direction and spacing
❑ Rafter and over frame direction, size and spacing
❑ Wall Section Detail including:
Roof
❑ Slope/ roofing material/ underlayment/ ice dam protection
❑ Sheathing size and type
Ceiling
❑ Joist size and spacing
Wall
❑ Height/ top plate/ stud size and spacing/ sole plate
❑ Exterior sheathing size and type
Floor
❑ Joist size and spacing
Foundation Wall
❑ Concrete or Masonry unit width
❑ Earth to wood separation distance
Footing
❑ Size
Radon
❑ Passive system with Emil vapor barrier
Miscellaneous Construction Details
❑ Deck:
❑ Floor plan/ side view/ dimensions
❑ Floor Joist/ decking direction, size and spacing
❑ Stairway tread rise & run and nosing
❑ Ridge, eave and valley lines
❑ Beam and girder s , lo
❑ Truss or rafter size Ado
❑ Attic insulation/ air
❑ Size of ceiling gyp
❑ Siding/ exterior house wrap/ anchor bolts
❑ Insulation, vapor barrier, gypsum wall board
❑ Sheathing or concrete floor size/ insulation
❑ Footing bottom to finished ground level depth
❑ Horizontal & vertical reinforcement if any
❑ Reinforcement if any
❑ Active system with 6 mil vapor barrier
❑ Footings/ post/ and beam size and locations
0 Handrail / Guard height & spacing
Project Number: 10002887 Inv: I Application Date: 9/21/2010 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information:
_ �n,r r r. ue._
Permit Use: SFR W/ATT GAR Contact: CRAIG'S BUILDING SERVICES
Address: 11518 E ALKI
C - S - Z: SPOKANE VALLEY WA 99206
Setbacks: Front Left: Right: Rear: Phone: (509) 868-4862
Group Name:
Site Information: Project Name.
Plat Key: Name: Range District: Nort
Parcel Number: 46344.1506 Block: Lot:
SiteAddress: 5210 N KELLER RD Owner: Name: SHERRILL, MICHAEL A & KATH
Address: 10415 N MCCOY RD
Location:: CSV NEWMAN LAKE, WA 99025-8460
Zoning: R-3 SF Res District
Water District: 001 TRENTWOOD Hold: ❑
Area: 22,023 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review Released By:
Originally Released: 9/21/2010 By: tmelbourn
Landuse/Zoning/HE Conditions Released By:
Originally Released: 9/14/2010 By: tschmidt
Sewer Review Released By:
PER PHONE CONVERSATION WITH ROGER RIVERS
Originally Released: 9/14/2010 By: jdavis
Permits:
Operator: JD Printed By: jmm Print Date: 9/21/2010
Project Number: 10002887 Inv: I Application Date: 9/21/2010 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: Craig's Building Services
Address: 11518 E Alki
SPOKANE VALLEY WA 99206
Building Permit
Firm: Craig's Building Services
Phone: (509) 868-4862
Contractor: Craig's Building Services
Address: 11518 E Alki
SPOKANE VALLEY WA 99206
Item Description
GAS WATER HEATER
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS I DUCT
HOOD -TYPE II
Total Project:
Sg Ft Valuation
1,522 $150,601.90
1,522 $22,830.00
480 $7,200.00
616 $11,704.00
4,140 $192,335.90
Fee Amount
$1,514.55
$4.50
$605.82
Permit Total Fees: $2,124.87
Mechanical Permit
Firm: Craig's Building Services
Phone: (509) 868-4862
Units Unit Desc
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
3 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Operator: JD Printed By: jmm Print Date:
Fee Amount
$11.00
$3.00
$13.00
$33.00
$22.00
$82.00
9/21/2010
This Application:
Description Grp Tyne
Notes
Sq Ft
Valuation
1&2 FAMILY R-3 VB
1,522
$150,601.90
BASEMENT U R-3 VB
1,522
$22,830.00
DECK OPEN R-3 VB
480
$7,200.00
GAR WOOD U-1 VB
616
$11,704.00
Totals:
4,140
$192,335.90
Item Description
Units
Unit Desc
RESIDENTIAL PERMIT FEE
1
SELECT
WSBCC SURCHARGE
1
SELECT
SF PLNS RVW < 7999 SQ FT
1
SELECT
Contractor: Craig's Building Services
Address: 11518 E Alki
SPOKANE VALLEY WA 99206
Item Description
GAS WATER HEATER
GAS PIPING
HEAT PUMP OR A/C 0-3 TONS
VENTILATING FANS I DUCT
HOOD -TYPE II
Total Project:
Sg Ft Valuation
1,522 $150,601.90
1,522 $22,830.00
480 $7,200.00
616 $11,704.00
4,140 $192,335.90
Fee Amount
$1,514.55
$4.50
$605.82
Permit Total Fees: $2,124.87
Mechanical Permit
Firm: Craig's Building Services
Phone: (509) 868-4862
Units Unit Desc
1 NUMBER OF
3 # OF UNITS
1 NUMBER OF
3 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Operator: JD Printed By: jmm Print Date:
Fee Amount
$11.00
$3.00
$13.00
$33.00
$22.00
$82.00
9/21/2010
Project Number: 10002887 Inv: I Application Date: 9/21/2010 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: Craig's Building Services
Address: 11518 E Alki
SPOKANE VALLEY WA 99206
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
CLOTHES WASHER
FLOOR DRAINS
MISCELLANEOUS FIXTURES
Plumbing Permit
Firm: Craig's Building Services
Phone: (509)868-4862
Units
Unit Desc
Fee Amount
2
NUMBER OF
$12.00
4
NUMBER OF
$24.00
1
NUMBER OF
$6.00
1
NUMBER OF
$6.00
1
NUMBER OF
$6.00
1
NUMBER OF
$6.00
4
NUMBER OF
$24.00
$1,718.65
Permit Total Fees:
$84.00
Notes. ..... _ ;.
SEWER PERMIT REQUIRED ONCE SEWER PROJECT IS COMPLETE
Pavment Summa
Permit Type
Fee Amount
Invoice Amount
Amount Paid
Amount Owing
Building Permit
$2,124.87
$2,124.87
$572.22
$1,552.65
Mechanical Permit
$82.00
$82.00
$0.00
$82.00
Plumbing Permit
$84.00
$84.00
$0.00
$84.00
$2,290.87
$2,290.87
$572.22
$1,718.65
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: jmm Print Date: 9/21/2010
Spokan ~
O*Val -ey
cD2�0 L
Site Address: 0 N KELLER R
Parcel Number: 46344.1506 �—(DT
Project
Transmittal
City of Spokane Valley
Community Development
Department
11703 E. Sprague Ave, Suite B3
Spokane Valley, WA 99206
Phone: 509.688.0036
c� Q(_vct 1
Previous pre -app meeting F1
Plan revisions El
Transmittal Date:
Tuesday, September 14, 2010
Project Number: 10002887
Zoning: R-3 Water District: TRENTWOOD
Fire District: FD 01
Applicant: CRAIG'S BUILDING SERVICES Owner: SHERRILL, MICHAEL A& KATHERI
11518 E ALKI 10415 N MCCOY RD
SPOKANE VALLEY WA 99206 NEWMAN LAKE, WA 99025-8460
(509) 868-4862
e-mail:
Contact: CRAIG'S BUILDING SERVICES
11518 E ALKI
SPOKANE VALLEY WA 99206
(509) 868-4862
e-mail:
Contractor: Craiq's Building Services
11518 E Alki
LEY WA 99206
(509) 868-4862
Project SFR W/ATT GAR
Description:
e-mail:
Occupant:
e-mail:
Arch /Engineer.
e-mail:
Please send all plan review and project comments via e-mail to the
highlighted individuals.
For City Use Only
CITY Or, PLUS Project Number
Project Address .
Valley°
11703 E Sprague Ave Suite B-3 ®Spokane Valley WA 99206'
509.688.0036 ♦ Faz: 509.688.0037 ® permitcenter@spokanevalley.org
As part of our on-going commitment to customer service during the review process of your project
application, we are providing you with a TARGET DATE for the initial technical application review.. If for
any reason we cannot meet this date, we will contact you with a revised target date.
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your project application will have had its initial technical
review. It is not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on nn/ltiple applications and it
may be several days before they can look at your new or revised information.
Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the
expertise for dealing with reviewer comments would be the best choice for the entire review process.
o Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date, please feel free to contact its if you haven't heard from us
by your target date. Staff may contact you before the target date if the initial review is complete. By following this
procedure, you will save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required
documents, as indicated on your Pre -Application Checklist have been submitted or have been approved for deferred
submittal. This does not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free
from substantive flaws that would prevent technical staff from completing the technical review once it is started. When
this step is complete, your application will be routed to the appropriate staff and remain in their review queue until it
comes up for review.
3. Technical Compliance. Once an application is administratively complete, it is routed to technical staff for compliance
review. Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by
phone, fax, email, or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center. When all sections
of the application are received, a Permit Specialist will process the application and contact the person specified on your
application for permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by
the Permit Specialist at that time.
WHITE—APPLICANT PINK — BUILDING FILE REV 9/07
Kipui 1Qliv, Spokane Valley, WA 99206 PERMIT FEE: I
jVidll�y� (509)688-0036 FAX: (509)688-0037
www.spokanevalley.org
Community Development
Residential Construction " New Construction ❑ Accessory Bldg
Permit Application ❑ Addition/Remodel ❑ Deck
❑ Other:
SITE ADDRESS:
ASSESSORS PARCEL NO: _ 040'?f q 4 - I Gc. LEGAL DESCRIPTION: 54[( iq M F�if�✓�
Building Owner:
Name:
Address: j I
`I
City:
State Zip o
1
Phon :
Contact Person
Name:
Phone: q --
Describe the scope of work in detail:
Proposed Use: P,
Contractor:
Name: e `c . -5 6.4 ekG ?Y Leg
Address: ii C
i.
City: S' V&k_p Vctf(rte State: A Zip.
Phone:_Contra8a
Ea Date:
lL z
City Business Lic. No
Cost of Project: $ ` y 6To ()t
**************The following MUST be complete: write N/A if nota licable **********************
HEIGHT TO PEAK: Y o
DI MENSIONNS:r 1 qtr
4 LigMAIN
# OF STORIES: Q
TOTAL HABITABLE SPACE:
FLOOR TO SQ.
2w FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
FTG: r qq
K)A
(�aG
. AREA- '
FINISHED BASEMENT
SQ. FTG:
GARAGE SQ. FTG,
Wo
DECK/COV. PATIO SQ. FTG:
30% SLOPES ON
YLe-5
PROPERTY:
# OF BEDROOMS. �y
CONSTRUTION�J TYPE:
HEAT SOURCE:
SEWER OR SEPTIC?
/
The permitee verifies, acknowledges and agrees by their it slgeic natu a t 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
SIGNATURE: s DATE:
Method of Payment:
❑ Cash Check ❑ Mastercard ❑VISA
Bankcard M Expires: VIN#:
Authorized Signature:
REVISED 2/15/07
Permit Center
11703 E Sprague Ave, Suite B-3
p Spokane Valley, WA 99206 PERMIT NUMBER:
j% ley• (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
Community Development perrnitcenter(&sspokanevalley.org
Mechanical Permit Application ❑ Commercial P4 Residential
- ♦ TTnL`vo.
of ■ L ---.
J
#UNITS
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Building Owner
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Over 100,000 BTU
Name: ` G
tl Phone:A SA -S-1(,
`
CXo1 Nla
Address: � �5 ME;l.c/
City:
State:
Zip: - Zs
Contractor
AIR CONDITIONER
Over 15-30 TON
Name: f ` -vta V _
Phone:
O
Over 30-50 TON
Address:I i E.
City:
State:
Zip�+t���C�
License No:"
City Busilness Lic:
s
Contact/Project Manager:
GAS LOG, FIREPLACE, & GAS INSERT
Name: SOV,)
Phone:z&x—
-Z
REPAIRS OR ADDITIONS
EXPIRES: VIN:
[]CASH ❑ CHECK ❑ VISA ❑ MC
CARD #: SIGNATURE
http://www.spokanevalley.org/uploadsIConununit3 DevelopmentIDocuments/Forms/Building/MechanicalPermitApplicationO4O3O9.doc
le
#UNITS
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Up to & including 100,000 BTU
FURNACES & SUSPENDED HEATERS -INSTALLATION OR RELOCATION
Over 100,000 BTU
DUCT WORK SYSTEM
HEAT PUMP/AIR CONDITIONER
0-3 TON
AIR CONDITIONER
Over 3-15 TON
AIR CONDITIONER
Over 15-30 TON
AIR CONDITIONER
Over 30-50 TON
AIR CONDITIONER
Over 50 TON
GAS WATER HEATER
GAS PIPING SYSTEM each outlet
GAS LOG, FIREPLACE, & GAS INSERT
APPLIANCE VENTS INSTALLATION, RELOCATION, REPLACEMENT
REPAIRS OR ADDITIONS
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
0 to 3 h 100,000 BTU or less
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 3 - 15 h -100,001 to 500,000 BTU
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 15 - 30 h - 500,001 to 1,000,000 BTU
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 30 h - 1,000,001 to 1,750,000 BTU
BOILER, COMPRESSORS, ABSORPTIONS SYSTEM
Over 50 h - over 1,750,000 BTU
AIR HANDLER DOES NOT include ducting)
Each unit up to 10,000 cfm, including ducts
AIR HANDLER DOES NOT include ducting)
Each unit over 10,000 dm
EVAPORATIVE COOLERS other thanportables)
VENTILATION AND EXHAUST
Each fan connected to a singe duct
VENTILATION AND EXHAUST
Each ventilations stem
VENTILATION AND EXHAUST
Each hood served by mechanical exhaust
INCINERATORS
Installation or relocation of residential
INCINERATORS
Installation or relocation of commercial
APPLIANCES
Range, Clothes Washer
UNLISTED APPLIANCES
Under 400,000 BTU
UNLISTED APPLIANCES
Over 400,000 BTU
HOOD
Type I
HOOD
Type 11
h
L P STORAGE TANK
WOOD OR PELLET STOVE INSERT
WOOD STOVE SYSTEM - FREE STANDING
EXPIRES: VIN:
[]CASH ❑ CHECK ❑ VISA ❑ MC
CARD #: SIGNATURE
http://www.spokanevalley.org/uploadsIConununit3 DevelopmentIDocuments/Forms/Building/MechanicalPermitApplicationO4O3O9.doc
le
1 L.l11llL L.L.IILGI C'
S06jOl , ne 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: /(XW Z d
Spokane Valley, WA 99206
jValley (509)688-0036 FAX: (509)688-0037 PERMIT FEE:
permitcenter@spokanevalley.org
Community Development
Plumbing Permit Application ❑ Commercial Residential
SITE ADDRESS:
1 IA _c—,c on - I l i1. 4
Building Owner
Name: 'r -Phone:
Address: (�
City: is r . ` State:
'l///l!
Zip:
Contractor
Name:
Address: �i-City:
State:
Zip
License No:
City Bus ess Lic:
Contact/Project Manager.
Name:
Phone: �g —1
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS (per trap)
SINKS
Lav/Basins, Bar, Floor, Kitchen, Laundry, Utility, Janitor, Photo, X-ray, Food,
Prp/Culinary Pr/CulinaryMeat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area Case, Coil Trench, Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Alterations, Repair, Reversals
WATER USING DEVICE
Ice and/or Coffee maker, hose bib, steamer proofer, carbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
If Gas See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS I
Including traps, vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION
Water piping, drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
❑CASH JVCHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT: http://www.spokanevalley.org under the quick links for Forms, Master Fee Schedule.
http://Www.spokanevalley.orgluploads/CommunityDevelopment/Documents/Forms/BuildingIPlumbingPermitApplicationO4O3O9.doe
PLANNING DEPT. APPROVED
BY: .�
It
DATE:
I
.X,