2004, 02-11 Permit App: BLD-04-03538 Residence*Wane
.,, \iilley
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: 339 S SHELLEY LAKE LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner: CLIFF SCHMITZ CONSTRUCTION
Applicant: CLIFF SCHMITZ CONSTRUCTION
Address:
Lot: Blk: Parcel No:
Contractor: CLIFFORD SCHMITZ CONSTRUCTION
Address: 16520 E SECRETARIAT LN
VERADALE WA 99037 -
Application #: BLD -04-03538
Phone: (509) 999-7733
Phone:
Lic No:
(509) 922-4297
CLIFFSC104RF
Applied:
Issued:
Expires:
Zoning:
02/11/2004
08/09/2004
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
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
sfr
182516
19
59'6"X55
1
2
25
33
5' 6"
5
r-3
5-w
1
70 X 113
no
no
3
3
1
5
1
1
1
1
3
1
1
1
1
3
4
1
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
Total Calculated:
Deposits/Receipts:
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL
Initials / Datcvn
SP
Building
Planning
Public Works
/
otal Due:
583.42
1,458.55
4.50
18.00
18.00
6.00
30.00
6.00
6.00
6.00
6.00
18.00
15.00
10.00
10.00
10.00
3.00
40.00
2,248.47
0.00
SVOlune
"W6,4sr�nIEWED FOR CODE COM�PLLIANCE
KANE VALLEY BUIL 1G )DIVIISION
2,248.47
THIS IS NOT A RECEIPT
go
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: 339 S. 5 1-faL G y & 14- Kt / Jt >t
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: 1-,1 BLt. , S #611,1hi 1k ,r
PERMIT DESCRIPTION:
IIFTII,DING PERMIT CI CHANGE IN USE a GRADING
EI SIGN Q TENANT
ICJ -RELOCATION
a MANUFACTURED HOME
CI -O fHER
OWNER / APPLICANT INFORMATION
a OWNER:
PHONE: FAX:
AIDRESS:
CITY,STATE, ZIP
_CONTRACTOR: et. iF-P 5Cehen t GenaST
PHONE: q qq-'7 733 FAX: .r
ADDRESS: / (QST ' C • SL.Gi? nhe/pf vUIW. !y
CITY,. STATE, ZIP
WA ST CONTRACTOR LICENSE # cz/A- SGLDyIQt
0
APPLICANT:
PHONE:
FAX:
ADDRESS:
CITY, STATE, ZIP
ARCHITECT:
PHONE: FAX:
viz ADDRESS:
CITY, STATE, ZIP
CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT:
BUILDING HEIGHT TOOPPAK: /q
BUILDING DIMENSIONS:
NUMBER OF STORIES: 1
NUMBER of BEDROOMS:
FLANKING SETBACK:
FRONT SETBACK: ZS
REAR SETBACK: 3 3
LEFT SETBACK: �6
30% SLOPES ON PROPERTY:
C4CCUPANCY GROUP
CONSTRUCTION TYPE: r
STRUCTURES ON PROPERTY: -p
CRITICAL AREAS:
CURRENT PROPERTY SIZE:._
CURRENT PROPERTY USE: /UaR,e
CURRENT SEPTIC USE: •
CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
MAIN FLOOR SQ FT: /i7
2ND FLOOR SQ FT: ,p
UNFIN BASEMENT: /O
FINISHED BASEMENT: %
f QPA�c.
(ago
zjD
COVERED DECK:
DECK:
MANUFACTURED HOME SIGN
WIDTH: LENGTH:
YEAR: PIT SET:
MANUFACTURER:
SQ FT OF SIGN: HEIGHT Or SIGN:
# OF SIGNS: AREA OF EXIST SIGN:
TYPE OF SIGN:
RELOCATION FIRE SAFETY
PREVIOUS ADDRESS:
PROPOSED USE:
FIRE SPRINKLER: FIRE ALARM:
PAINT BOOTH: TENT:
FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
WA STATE NON-RESIDENTIAL ENERGY CODE
PLANS EXAMINER:
PHONE: FAX:
ADDRESS:.
CITY, STATE, ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY, STATE, ZIP
SPECIAL INSPECTIONS
BOLTING °CONCRETE ® REINFORCEMENT
FIRM NAME:
INSPECTOR(S):
PHONE:
® WELDING
FAX:
BUILDING STAFF USE ONLY
1
IS PUBLIC SEWER AVAILABLE: ® YES ® NO
IS PUBLIC WATER AVAILABLE: ® YES ® NO IF. YES, WHICH WATER DIST/IRR:
IF YES: COUNTY ® CITY
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES 0 NO
DATE:
METHOD OF PA YMENT•
Ll0
1
STAFF:
CASH CHECK
0
WSA
BANKCARD #; EXP/RES: VIN#
AUTHOR/ZED SIGNATURE'
*FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
IETHOD 0
] CASH
ATE:
SAane
40,,0 Valley
Plumbing Permit Application
11707 East Spragrie Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
# OF NITS
OWNER:
COST
PHONE (Daytime Contact):
MAILING ADDRESS:
1
TOILETS
(street)
(city/state)
(ZIP)
CONTRACTOR:�,`�
S P�.u.mB b
LICENSE #:
2
MAILING ADDRESS:
PHONE #:
X$6
-
(street)
(city/state)
(ZIP)
PLUMBING FIXTURES
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF NITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6
-
2
URINALS
X$6
-
3
TUBS
X
-
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
7
X
$6
-
5
SINKS
LAVS/BASINS, BAR, FLOOR KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
.S"..
X
$6
-
6
DISHWASHER
(
X
-
7
CLOTHES WASHER
1
X
$6
-
8
GARBAGE DISPOSAL
'
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE BIB,
STEAMER, PROOFER, CARBONATOR
SWAMP COOLER
3
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
] CHECK
,2Ce5I!;
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
• •
TOTAL PERMIT FEE DUE:
ANKCARD NUMBER:
UTHORIZED SIGNATURE:
Spokane
, .. Valley
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: 33 q
PERMIT
USE:
OWNER
PHONE (Daytime Contact):
MAILING ADDRESS:
COST
(street) (city/state)
(ZIP)
CONTRACTOR: 64, e p.././61,14 �� j , _} 06
(4 �i 7�fi'+
LICENSE #:
- OR < 100,000
MAILING ADDRESS:
PHONE #:
515
-
(street) (city/state)
(ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
- OR < 100,000
'
X
515
-
2
FUEL BURNING APPLIANCE
> 100,000
X
519
-
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
550
-
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
- or < 400,000
X
550
-
6
USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
5100
-
7
BOILER/REFRIGERATION
1-100M BTU
X
515
-
5
BOILER/REFRIGERATION
101- 500M BTU
X
$28
-
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39
-
10
BOILER/REFRIGERATION
1001 - 1,750M BTU
X
557
-
11
BOILER/REFRIGERATION
+1750M BTU
X
595
-
12
GAS LOG, GAS INSERT, GAS FIREPLACE
-
1
X
510
-
13
RANGE
-
X
510
-
14
DRYER
-
X
510
-
15
FUEL BURNING WATER HEATER
-
X
510
-
16
MISC FUEL BURNING APPL.
-
X
510
-
17
GAS PIPING (ea. Outlet)
-
3
x
51
-
18
DUCT SYSTEMS
-
X
510
-
19
VENTILATING FANS
-
li
X
510
-
20
AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
512
-
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
519
-
22
EVAPORATIVE COOLERS
-
X
510
-
23
TYPE I HOOD
-
X
550
-
24
TYPE II HOOD
-
1
X
510
-
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512
-
26
AIR CONDITIONER
3-15 TON
X
$20
-
27
AIR CONDITIONER
15-30 TON
X
525
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
560
-
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
$25
-
KED
— p{`
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Agri
SpoKANE COINTY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 339 S SHELLEY LAKE LN
VERADALE, WA 99037
Parcel Number: 4524L1821
Subdivision:
Block: 1 Lot: 1
Zoning: UNK Unknown
Owner: CLIFF SCHMITS CONSTRUCTION
Address: 16520 E SECRETARIAT
VERADALE, WA 99037-9523
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 04000547 Inv: 1 Issue Date: 2/10/2004
Permit Use: SEWER CONNECTION - SHELLEY LAKE 1ST
Applicant: CLIFF SCHMITZ CONSTRUCTION
16520 E. SECRETARIAT
VERADALE, WA 99037 Phone: (509) 922-4297
Contact: CLIFF SCHMITZ CONSTRUCTION
16520 E. SECRETARIAT
VERADALE, WA 99037 Phone: (509) 922-4297
Setbacks - Front:
Group Name:
Project Name:
Left: Right:
Rear:
Permits
Sewer Connection Permit
Contractor: FOLSOM EXCAVATING INC License #: FOLSOEI994D0
SEWER CONNECTION 1 $85.00 PROCESSING FEE
Total Permit Fee:
FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES 8:30-5:00 PM MONDAY THRU FRIDAY
$15.00
$100.00
Call for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRED.
Contractor or applicant is to field locate and confirm the elevation and position of sewer stub prior to any other excavation.
Sewer stubs are to be checked prior to connection to ensure that they have acceptable grade and are clear and unobstructed to the main sewer.
Sewer lines should be constructed to allow for gravity flow from the lowest level of the structure.
This permit must be presented to the job site inspector for verification. To locate buried cables, gas piping, water lines, etc.
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIOR TO ANY EXCAVATION THE "CALL BEFORE YOU DIG" CENTER BE
NOTIFIED. CALL BEFORE YOU DIG AT LEAST 2 WORKING DAYS IN ADVANCE, (509)456-8000.
Spokane County Code requires the installer comply with all requirements of the Washington State Dept of Labor and Industries, including
those related to trench safety.
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date Receipt # Payment Amt
2/10/2004 457 $100.00
Processed By: BURRIS, ROBIN
Printed By: WENDEL, GLORIA Page 1 of 1
PERMIT
NOTICE
It is the responsibility of the applicant/permittee to see to it that the use described on the front of this permit complies with applicable codes and
requirements and that required inspections are requested. Failure to request inspections as listed below and obtain the necessary approvals before
progressing beyond the point where inspections are required may necessitate removal of certain parts of the construction at the applicant's/permittee's
or property owner's expense. At a minimum, the following inspections ARE REQUIRED by County Code:
1. FOOTING - when forms and reinforcement are in place and prior to placement of concrete—all structures, including manufactured homes.
NOTE: This inspection includes review of the structure's setbacks from property lines. Minimum setbacks are established by County zoning
regulations. Typically, side and rear yard setbacks are measured from property lines, while setbacks for yards abutting streets are measured from
the property line or the center line of the roadway right-of-way, whichever provides the greater setback from the center line of the roadway right-of-
way. Curb lines and fence lines are not necessarily indicative of property lines. In some residential areas, the County can own as much as 20 feet of
right-of-way between your property and the actual improved street/curb. The responsibility to comply with applicable setback provisions lies solely
with the permittee—neither Spokane County nor its authorized representatives assume any responsibility for the verification or location of your
property lines. Please verify their location prior to locating your structure. Failure to properly locate the structure may require its relocation at the
owner's/permittee's expense.
2. FOUNDATION - when forms and reinforcement are in place and prior to placement of concrete.
3. FRAMING - after all framing, bracing and blocking is in place, and prior to concealing.
4. INSULATION - prior to the installation of drywall.
5. PLUMBING - after rough -in, before covering, and final.
6. MECHANICAL - rough -in of piping, before covering, metal chimneys before concealment, and final.
7. FINAL - when complete and prior to occupancy and/or use. Please provide 24 hours notice. All permits require final inspection.
NOTE: In addition to inspection of the structure, this inspection includes review of site improvements (typically depicted on the approved site plan)
required by ordinance or as a condition of approval of this permit. Items such as the installation of fire hydrants, fire department access, on-site
drainage ("208 swales"), road improvements, parking, and landscaping are common requirements of a permit/site plan which must be com-
pleted prior to final approval of a building or issuance of a Certificate of Occupancy.
8. MANUFACTURED HOMES - Final inspection required when complete, stairs, handrails, skirting, etc. installed, and prior to occupancy; completed
inspection record card must be available on site.
9. SEWERS - prior to cover
10. RIGHT-OF-WAY/APPROACH - prior to placement of concrete, or, if gravel approach, after completion.
In addition to the above, any plumbing or mechanical systems or material which would be concealed by framing, drywall, concrete, etc., must be inspected
prior to cover. Check with the department for "special inspections" in conjunction with commercial projects.
FOR INSPECTIONS:
TO INSURE PROMPT SERVICE, PLEASE GIVE ONE WORKING DAY/24 HOUR NOTICE .
PARTS OF YOUR PROJECT MAY REQUIRE PERMITS AND INSPECTIONS
FROM MORE THAN ONE AGENCY.
• Building, plumbing, mechanical and fire inspections, Department
of Building & Planning
477-3675
• Construction in a flood plain, Division of Engineering & Roads
477-3600
• Electrical wiring, State Department of Labor and Industries
324-2640
• On-site waste disposal system, Spokane Regional Health District
324-1560
• Road cuts for utilities or driveways, Division of Engineering &
Roads - 48-HOUR NOTICE REQUIRED
477-3600
or State Department of Transportation
456-3000
• Sewer connection, Division of Utilities
477-3604
or City Public Works Department
625-6300
PERMIT EXPIRATION AND REFUNDS
Unless otherwise noted, this permit will be considered null and void by limitation if the work authorized by the permit is not commenced or is stopped for
a period of 180 days, unless a written request for an extension of the permit is received and approved by the Building Official prior to expiration. At a
minimum an inspection should be requested at least once every 180 days to assure the validity of the permit. A permit may be renewed within one year
of the date of expiration for one-half the original fee, subject to certain limitations—please call us if you have any questions.
All refund requests must be made in writing by the applicant/permittee (shown on the reverse) no later than 180 days after the date of fee payment.
Refunds of not more than 80% of the permit fee paid may be authorized when no work has been done under the permit. No refunds may be authorized
more than 180 days after fee payment.
MISTAKE?
If you think we've made an error in processing this permit or in conducting inspections pertaining to it, or find erroneous information in the permit, please
bring it to our attention immediately by filing a written request for correction within 10 working days of discovery. All such requests should be directed to
the Division of Building and Code Enforcement at the below address.
Spokane County Department of Building & Planning
1026 West Broadway Avenue
Spokane, WA 99260
Phone: (509) 477-3675 Fax: (509) 477-4703 TDD: (509) 477-7133
FORM 30-050202 BLDG PERMIT
330 S. S\-q.LL .V LMK LANE
LOT
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