2004, 10-12 Permit App: BLD-04-07905 Residencebf�
Spft'f1okane
., 0.1cValley
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: 364 S SHELLEY LAKE LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
C & G PARTNERSHIP
MADDEN CONSTRUCTION
10601 E NIXON LN
SPOKANE VALLEY, WA 99206
KEVIN MADDEN CONSTRUCTION
10601 E NIXON LN
SPOKANE WA 99206-3794
Application #: BLD -04-07905
Applied:
Issued:
Expires:
Lot: Blk: Parcel No: 45241.1801
Phone: (509) 924-6497
Phone:
Lic No:
(509) 927-7526
KEVINMC146J5
Zoning:
10/12/2004
04/10/2005
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
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
HEAT PUMP/AIR COND 0 - 3 TON
sfr
164811
30
59' 6" X 54
1
3
30
59
10
9
r-3
5-n
1
11161
no
no
3
3
1
6
1
1
1
2
1
1
1
1
3
4
1
1
Fees:
PLAN CHECK FEE
TYPE II HOOD
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
HEAT PUMP/AIR COND 0 - 3 TON
Total Calculated:
Deposits/Receipts:
Planning
-Public Works415/.1.-4262/S4‘..4
Petal Due:
CITY OF SPOIUINE VALLEY
APPRCNED FOR SUBMITTAL
/ Date
Building /
/1/1-2-/44
543.10
10.00
1,357.75
4.50
18.00
18.00
6.00
36.00
6.00
6.00
6.00
12.00
15.00
10.00
10.00
10.00
3.00
40.00
12.00
2,123.35
0.00
2,123.35
SPiane
®,•��alky
EVIEWED FOR CODE COMPLIANCE
SPOKANE VALLEY BUILDING DIVISION
THIS IS NOT A RECEIPT
Spoanlane
4,000Valley
• BUILDING PERMIT APPLICATION WORKSHEET.
City of. Spokane Valley Community. Development Department
Building Division
1170.7 E. Sprague Avenue, Suite 106
• • Spokane Valley, WA 99206
. Phone: (50.9) 688-0036; Fax: (509) 588-0037
REQUIRED SITE INFORMATION. •
ti
Street Addres: 5h Q.k E. 1✓a-h/e__: •
,-;(6,(4_1 cc
Assessor's Tax Parcel Number(s): •
Legal Description:
PERMIT DESCRIPTION:
Building Permit
Relocation
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner:
Phone: •
Address: .I L'L')f
TJ s r i-(,
Fax:
• ('I'ak!HI j),i ,F .
City • State Zip Code
0 Contractor: • k'eY•iN /1 -Au dde '
Ptione:942',/-64/97 2/7 6700
Address: /ao/ iY Xo,,f a *
ko kao/e V/7 1-tla-'
City ' • State
99a 0G
Zip Code
WA State Contractor License #: Kevi1 /►1C` /ykJ
a
Applicant: I'l1 d d et,( Con/5i-
Phone:
on/sz-
Phone: Fax:
Address:
City , State Zip Code
❑ Architect: Kev,ri /1-a.dded
Phone: ,Iii- 6 Ze9 to Fax:
Address k"`•7 0 60 I #, y ori J,,., r el.
Pa k Gini I,t10,-� ..99;7-e G!
City • State Zip Code
Contact: �'c V, it/ 0C' irra ei', /77a.dd e/✓
PERM1TTBUIkDDING.•INF.QRMA IO,N •
HEIGHT TO PEAK / •
_ 6
D6MENSI0I4S:#
QF STORIES: • .
0 ,;v/e.....
MAIM FLOOR TO SQ. FTG:
2" "FLOOR SQ: FTG:
-UNFI l4 BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG; .
o
GARAGESQ: FTG:
• • • 60a.
DECtf/CQV. PATIO SQ. FTG:
o
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
.# OF BEDROOMS:
TOTAL HABITABLE SPACE:
/lo 6 O
IMPERVIOUS SURFACE AREA:
0
•
COST OF PROJECT:, f.30%
SLOPES ON PROPERTY:
, /v'e
.
*SEWER OR ON-SITE SEPTIC
-SYSTEM? Sever-
MANUFACTURED HOME
Width;
Manufacturer: .
Length:
Year:
Pit Set:
• RELOCATION •
. • Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint.Booth:
Daterfime:
Tent: • Fireworks Display: Blasting:
Valuation: . Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE .
Plans Examiner:
Address:
Phone: Fax:
City
Inspector: Phone: •
Address:
State
Fax:
Zip.
City
State .
Zip
SPECIAL INSPECTIONS
Q BOLTING 0 CONCRETE
Firm Name:
0 REINFORCEMENT
Phone:.
Inspector(s):
0 WELDING
Fax:
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that 4). 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) AU construction is to. be clone 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 ofresulting 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 0 Check . ❑ Mastercard . 0 VISA 0 Other
• Bankcard #: Expires: , VIN#:
Authorized Signature:
••••"sii,
Sane
.,•••$Valley
Project Address:
Owner, l 'e.\1$ ,J r NI
Mailing Address: ,€ /C/ I `x ori
Contractor:
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Cornmunitt 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
Permit Use:
Phone (Daytim /Contact): Al.\/ird /)7a,4f a r(
n Mira W E- V 6 j' L,P/Gi.. d!
itY `
State Zip Code
r�` License #: ® r/ Cs�' "' � ' c " Phone #: ".. -"'.0 7 (1 0
Mai ing Address: ? 3 < r
e t/Ly
Atha. 947,2 0 4
City State Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
*OF
UNITS
' X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100 000
X
515.00
=
UEL-BURNING-APPLIANCE
Mare than100,000
X
519.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
$
USED APPLIANCE (WSEC min. AFUE
rating
Equal to or fess than 400,000
X
$50.00
-
B
USED APPLIANCE (WSEC min. AFUE
rating)
More than 400,000
X
5100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU •
: X
515.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
528.00
=
9
BOILER/REFRIGERATION
501 -1,000M BTU
X
539.00
=
10
BOILER/REFRIGERATION
1,001 -1,750M BTU
X
$57.00
=
11
BOIL€RIREFRIGERATION
More than 1,750M BTU
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
/ •
X
$10.00
=
13
RANGE
X
510.00
=
14
DRYER
X
510.00
=
15
FUEL BURNING WATER HEATER
/
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
.
17
GAS PIPING (each outlet)
/X
51.00
=
18
DUCT SYSTEMS
.�
X
$10.00
=
19
VENTILATING FANS
a•
X
$10.00
=-
20
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
. 512.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00
=
22
EVAPORATIVE COOLERS
' X
510.00
=
23
TYPE t HOOD
X
850.0.0
=
24
TYPE II HOOD
X
510.00
=
25
HEAT PUMP/AIR CONDITIONER
03 TON
/
• X
' 512.00
=
26
AIR CONDITIONER
3-15 TON
,
X
520.00
=
27
AIR CONDITIONER
15-30TON
X
$25.00
=
28
AIR CONDITIONER
30-5G TON
' X
' $35.00
=
29
AIR CONDITIONER
More than. 50 TON
X
1
$60.00
• =
30
LPG STORAGE TANK
X
; $10.00
=
3.1
WOOD OR PELLET STOVE/INSERT
L
X
$10.00
=
32
WOOD STOVE- FREE STANDING
X
�
' 525.00
=
METHOD OF PAYMENT:
Q CASH 0 CHECK 0 VISA 0 MC
CARD #.
DATE:
SUBTOTAL
PROCESSING FEE
835.00
EXPIRES:
TOTALPERMIT FEE DUE:
AUTHORIZED SIGNATURE:
PLUMBING PERMIT APPLICATION
Cify 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
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
State Zip Code
City
Contractor: License #: Phone #:
Mailing Address:
City
State
Zip Code
2
3
4
5
7
6
9
10
12
13
14
1
1
DESCRIPTION OF WORK
# OF
UNITS
X
COST
-
TOTAL
AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6.00
URINALS
X
56.00
TUBS
X
$6.00
=
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-S(TE BUILT
LAVS!BASINS, BAR, FLOOR.
KITCHEN, LAUNDRY, muff,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
X
16.00
16.00
=
DISHWASHER
X
$6.00
=
CLOTHES WASHER
X
$6.00
=
GARBAGE DISPOSAL
X
$6.00
=
WATER SOFTENER
X
$6.00
=
ELECTRIC HOT WATER TANK
NOTE W GAS, SEE MECHANICAL
X
$6.00
=
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,.
CONDENSATE
X
$6.00
=
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
=
FOUNTAINS, DRINKING
X
$6,00
=
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER
CARBONATOR, SWAMP COOLER
X
$6.00
=
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK '
VALVE, ANDRP.B.P.D. FOR:
VATS, TANKS, BOILERS
X
66.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
$6.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
$6.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
METHOD OF PAYMENT:
0 CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
BANKCARD NUMBER:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
ADORESS
ROAD WIDTH _woo
FRONT F
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