2005, 05-03 Permit App: 05001404 ResidenceProject Number: 05001404 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/03/2005 Page 1 of 3
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE -
NATURAL GAS
Setbacks: Front 30 Left: 7 Right: 6 Rear: 57
Site Information:
Plat Key:
Name:
Contact: MADDEN CONSTRUCTION
Address: 10601 E NIXON AVE
C - S - Z: SPOKANE VALLEY, WA 99206
Phone: (509) 924-6497
Group Name:
Project Name:
SHELLEY LAKE 01ST ADD PUD District: East
Parcel Number: 45241.1803 Block: 1
SiteAddress: 352 S SHELLEY LAKE LN
Location:: CSV
Zoning: UR -22
Water District:
Area: 9,428 Sq Ft
Nbr of Bldgs: 1
Urban Residential -22
Width: 0
Nbr of Dwellings: 1
Review Information:
Lot: 3
Owner: Name:
Address:
MADDEN CONSTRUCTION
10601 E NIXON AVE
SPOKANE VALLEY, WA 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 30
Review
Site Plan Review
Released By: L.4411 ('
Plan Review
Released By: L 1/ .„),E,
,
1/471
Sewer Review
Permits:
Operator: K_C Printed By: K_C
Print Date: 05/03/2005
Project Number: 05001404
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/03/2005 Page 2 of 3
Contractor: KEVIN MADDEN
Address: E. 10601 NIXON LN
SPOKANE, WA 99206
Group: R-3
Total Area
Building Height
Stories
Dwelling Units
Description
2ND FLOOR
BASEMENT U
CARPORT
GARAGE
RESIDENCE
Type: VB
2282
33
2
1
Building Permit
Firm: KEVIN MADDEN CONSTRUCTIO
Phone: (509) 924-6497
Building Characteristics
Grp Type Notes
R-3 VB
R-3 VB
U-1 VB
U-1 VB
R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: KEVIN MADDEN
Address: E. 10601 NIXON LN
SPOKANE, WA 99206
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
This Application:
Total Project:
Sq Ft Valuation Sq Ft Valuation
970 $72,439.60 970 $72,439.60
532 $7,980.00 532 $7,980.00
80 $1,200.00 80 $1,200.00
1,132 $21,508.00 1,132 $21,508.00
780 $58,250.40 780 $58,250.40
Totals: 3,494 $161,378.00 3,494 $161,378.00
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$1,340.95
$4.50
$536.38
$1,881.83
Firm: KEVIN MADDEN CONSTRUCTIO
Phone: (509) 924-6497
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
3 # OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: K_C Printed By: K_C
Permit Total Fees:
Fee Amount
$10.00
$12.00
$3.00
$30.00
$10.00
$10.00
$10.00
$85.00
Print Date: 05/03/2005
Project Number: 05001404 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 05/03/2005 Page 3 of 3
Contractor: KEVIN MADDEN
Address: E. 10601 NIXON LN Phone: (509) 924-6497
SPOKANE, WA 99206
Plumbing Permit
Firm: KEVIN MADDEN CONSTRUCTIO
Item Description
TOILETSBIDETS
SINKS
SHOWERS
TUBS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
FLOOR DRAINS
WATER USING DEVICES
Units Unit Desc
2 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$12.00
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$12.00
DO NOT ISSUE SEWER PERMIT - OK TO ISSUE HOUSE PER ROGER 10/27/98
OK TO ISSUE SEWER PERMITS FOR:
BLK 4-L 1 BLK5-L2,16,18
BLK 6 - L 1,3,5,6,9,10 BLK 7 - L 1,2
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount
$1,881.83 $1,881.83
$85.00 $85.00
$72.00 $72.00
Amount Paid
$0.00
$0.00
$0.00
$72.00
Amount Owing
$1,881.83
$85.00
$72.00
$2,038.83 $2,038.83 $0.00 $2,038.83
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: K_C Printed By: K_C
Print Date: 05/03/2005
.000p�kane
1
1'1 MON
REQUIRED SITE INFORMATION
BUILDING PERMIT APPLICATA, N WORKSHEET
pokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
Street Address:
L4LE L
Assessor's Tax Parcel Number(s):
Legal Description:
(-4 ,3771- 6,41
PERMIT DESCRIPTION:
Srg
fEr Building Permit ❑ Change in Use ❑ Grading
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety
❑ Manufactured Home
❑ Other
1
OWNER/APPLICANT INFORMATION
cea
Owner: 1>✓1Ctd(6 1 CD 171S
Phone: "I Fax:
Address: I1.' 1 E-
5,96 V
5,96V a UPI
City State
Contractor:
5 tip �, ;
G
Zip Code
Phone: Fax:
Address:
City State
WA State Contractor License #:
ixJ
Applicant: 5 Ctv1'4, •
Phone: Fax:
Address:
City
0 Architect:
State Zip Code
Phone: Fax:
Address:
Zip Code City
Spokane Valley Bus. Liscense #:
Contact:
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: 3 3 +
DIMENSIONS: q3 x s---.
# OF STORIES:
; L t 't Etu V tr
MAIN FLOOR TO SQ. FTG: ,-
2ND FLOOR SQ. FTG: C -1 c
UNFIN BASEMENT SQ. FTG: ,
FINISHED BASEMENT�SQ. FTG:
GARAGE SQ. FTG: ,� 3 (
DECK/COV.���SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTI TYPE:
HEAT SOURCE:
# OF BEDROOMS: 3
TOTAL HABITABLE SPACE:
IMPERVIOUS SUjjFACE AREA:
COST OF PROJECT:
30% SLOPEASM PROPERTY:
SEWER -OR ON-SITE SEPTIC
MANUFACTURED HOME
Width:
Manufacturer:
Length:
Year:
Pit Set:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
0 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)
0 Cash 0 Check ❑ Mastercard 0 VISA 0 Other
Bankcard #:
Authorized Signature:
Expires:
VIN#:
,A,
$0kal De
diValleY
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Project Address: Permit Use:
Owner. Phone (Daytime Contact):
Mailing Address:
City
State Zip Code
Contractor. License #: Phone #:
Mailing Address:
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
,,
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
1
X
$6.00
=
7
CLOTHES WASHER
/
X
$6.00
=
8
GARBAGE DISPOSAL
/
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
1
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
1
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
S6.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
DATE
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Project Address:
Owner:
Mailing Address:
Contractor:
MECHANICAL PERMIT APPLICATION "
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
Mailing Address:
License #:
City
State
Zip Code
Phone #:
7in Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
=
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 -100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
=
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
/
X
$10.00
=
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
/
X
$1.00
=
18
DUCT SYSTEMS
/
X
$10.00
=
19
VENTILATING FANS
.3
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
$15.00
=
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
=
33
REPAIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
ZON
A E L
ROAD WIDTH �(.'
FRONTS FLANKING 1
COMMENTS
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