2003, 06-25 Permit App: BD-03-701 Residence. 1 +. Date: �k/OD Page 1 of 2
Project Number 0 3_ Inv: 1 Application g
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information: -_
Permit Use: Contact: MADDEN, KEVIN M
Address: 1214 S PROGRESS RD
C - S - Z: VERADALE, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 927-7526
Group Name:
Site Information: Pr I oject Name: -
Plat Key: Name: SHELLEY LAKE PUD District: F
Parcel Number: 45242.1310 Block: 3 Lot: 10
SiteAddress: 620 S SHELLEY LAKE LN
RADVE DALE, WA USA 99037
Location:: VER
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: 9,652 Sq Ft width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: ,
BUILDINGS:
PLANNIN
ENGINEERS:
FIRE A(ST
Owner: Name: MADDEN, KEVIN M
Address: 1214 S PROGRESS RD
VF,RADALF. WA 99037
Hold:
DO
Depth: 0 Right Of Way ( :
APPROVALS
SGS
00 UT -3D > �95-q 10 7 (o
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APPROVED
70
E c E p w E
D,
J U N 2 b 2003
D
U � L 0 H H
Airlead.y,
Lovely,11111111
I magi vie It fiMi5hed,,,
With YDIAR CUIUrsl,
Valleyway
Offered at $145,000
• New Madden Homes Design
• Three Main Level Bedrooms, Two Baths
• 15.5 x 13 Ft. Master w/Double Closets & 3/4 Bath
• Future Family Room w/Slider, Bedroom & RI Bath Down
Trevor Windhorst, GRI
Office: 891-0225
Mobile: 216-2090
Wine mere
Windermere Real Estate/Valley, Inc.
12929 E. Sprague, Spokane, WA 99216
• Beachwood Kitchen has Range, Dish-
washer, Disposal, Pantry & Eating Bar
• Dining Room w/Waterfall Ceiling Treatment
• Main Floor Laundry
• Gas Furnace & Water Heater
• Vinyl Windows
• Four Car Tandem Garage
• Partially Fenced Backyard
• Public Water & Sewer Q
tlT! (�111ijrla
Sin.
Mechanical Permit Application
PROJEcr
ADDRESS: �O� O
l� 1 e`er ��(��
PE RMIT
COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE
I-ISE:Arew
OWNER: y
$15
PHONE (Daytime Contact):
MAILING ADDRESS,::
X
$19 -
3 UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
(street)
(city/st e)
(ZIP)
CONTRACTOR:
$100 -
LICENSE
MAILING ADDRESS:
X
PHONE #:
6 USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
(street)
(ci /state
0p)
DESCRIPTION OF WORK
k OF UNITS
X
COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE
- OR < 100,000
X
$15
2 FUEL BURNING APPLIANCE
> 100,000
X
$19 -
3 UNLISTED APPLIANCE (ADDITIONAL FEE)
- OR < 400,000
X
$50
4 UNLISTED APPLIANCE (ADDITIONAL FE4
> 400,000
X
$100 -
5 USED APPLIANCE (WSEC min. AFUE rating)
- or <400,000
X
$50
6 USED APPLIANCE (WSEC min. AFUE rating)
> 400,000
X
$100
7 BOILER/REFRIGERATION
1-100M BTU
X
$15 -
8 BOILER/REFRIGERATION
101- 500M BTU
X
$28 -
9 BOILER/REFRIGERATION
501-1,000M BTU
X
$39 -
10 BOILER/REFRIGMATION
1001-1,750M BTU
X
$57 -
BOILER/REFRIGERATION
+1750M BTU
X
$95
GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
RANGE
L
-
X
$10DRYER
_
X
$10FUEL
BURNING WATER HEATER
-
X
$10 -
16 MISC. FUEL BURNING APDL.
-
X
$10 -
17 GAS PIPING (ea: Outlet)
-
X
$1 -
18.I)vrTSYSTEM$
_
X
$10. ... _._._�...--
19 VENTILATING FANS
_
X
$10 -
20 AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
$12 -
21 AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19'
22 EVAPORATIVE COOLERS
- 419
X
$10
23 TYPE I HOOD
_
X
$50
24 TYPE II HOOD
-
X
$10 -
25 HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12 -
26 AIR CONDITIONER
3-15 TONS
X
$20 -
27 AIR CONDITIONER,
15-30 TON
X
$25 -
28 AIR CONDITIONER
30-50 TON
X
$35 -
29 AIR CONDITIONER
+50 TON
X
$60 -
30 1 LPG STORAGE TANK
-
X
$10 -
31 WOOD OR PELLET STOVE/RNSERT
-
X
$10 -
32 WOOD STOVE - FREE STANDING
-
X
$25 -
METHOD OF PAYMENT
❑ CASH ❑ CHECK ❑ ❑ _.. i
DATE:
BANKCARD NUMBER --
AUTHORIZED SIGNATURE:
EXPIRES:
SUBTOTAL:
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
I < ,
�ne
,,,;. VaJ ley
Plumbing Permit Application
"ADDRESS:
(
`P e
� PERMIT
`(�USE:'(r
GARBAGE DISPOSAL
��/'/1�G�d�T
WATERSOFTENER
PHONE a
(D ytime Contact)
�DRESS: Y
11
FLOOR DRAINS
12
FOUNTAINS, DRINKING
"6-1406101
WATER PIPING/DRAIN-IN
WASTE, VENT,'PLUMBING
REVERSAL
X21
(street)
(ci
/stat )+
SPRINKLER SYSTEM
CONTRACTOR: f ,
I
jf
LICENSE #:
GREASE TRAP, SAND TRAP, CHEMICAL
MAILING ADDRESS:
PHONE #;
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
20 IMISC.
/
Y
�(/sta
(street)
e) Il')
PLUMBING FIXTURES
DESCRIPTION DETAILS
WATER CLOSET, BIDETS
ALS
4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT
5 SINKS LAYS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
7
CLOTHES WASHER
8
GARBAGE DISPOSAL
9
WATERSOFTENER
10
ELECT. HOT WATER TANK
11
FLOOR DRAINS
12
FOUNTAINS, DRINKING
13
WATER PIPING/DRAIN-IN
WASTE, VENT,'PLUMBING
REVERSAL
NOTE: IF GAS, SEE MECHANICAL
AREA, .CASE, COIL, TRENCH, CONDENSATE
INSTALLATION, ALTERATION, REPAIR,
D-.1 ♦ i I ....... .......
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
17
SPRINKLER SYSTEM
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
20 IMISC.
PLUMBING FIXTURE
OD OF PAYMENT
i J . ❑ CHECK ❑ ,� ❑ `_
nooe��
rro�a■�■
r�ooa�►�
P�ooe��
X 1 $6
X $25
X $6
X $6 -
X . $6
SUBTOTAL:
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
EXPIRES:
ARD NUMBER•
RIZED SIGNATURE:
�Il]TY c>�rwy, ,
S e
Mechanical Permit Application
PROJECT �
ADDRESS:p�D
r�
PERMIT
COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE
`*0
OWNER y
$15 -
PHONE (Daytime Contact):
MAILING ADDRESS:
X
S19 -
A/,
- OR <400,000
L�
(street)
(city/st e)
(ZIP)
CONTRACTOR:
5100
LICENSE ,
MAILING ADDRESS:
X
PHONE #:
6 JUSED APPLIANCE (WSEC min. AFUE rating)
d!'
0101e Allew
(street)
(ci /state
( )
3THOD OF PAY
CASH ❑ C1
.TE:
DESCRIPTION OF WORK
# OF UNITS X
COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE
- OR < 100,000
X
$15 -
2 IFUEL BURNING APPLIANCE
-I00,000
X
S19 -
3 JUNLISTED APPLIANCE (ADDITIONAL FEE)
- OR <400,000
X
S50 -
4 JUNLISTED APPLIANCE (ADDITIONAL FEET
> 400,000
X
5100
5 JUSED APPLIANCE (WSEC min. AFUE rating)
--or < 400,000
X
S50 -
6 JUSED APPLIANCE (WSEC min. AFUE rating)
i 400,000
X
$100
7 BOILER/REFRIGERATION
1 - loom BTU
-40 X
$15 -
8 BOILER/REFRIGERATION
101- SWM BTU
X
$28 -
9 BOILER/REFRIGERATION
501-1,000M BTU
X
$39 -
10 BOILER/REFRIGERATION
1001-1,750M BTU
X
$57 -
11 BOILER/REFRIGERATION
+1750M BTU
X
$95 -
12 GAS LOG, GAS INSERT, GAS FIREPLACE
-
X
$10
13 RANGE
-
X
$10 -
14 DRYER
-
X
$10 -In
15 FUEL BURNING WATER HEATER
-
X
S10 -
16 MISC. FUEL BURNING ADPL.
-
X
$10 -
17 GAS PIPING (ea: Outlet)
-
X
$1 -
14 . QLTCCSYSTEM$
-
X
$lo.
19 VENTILATING FANS
-
X
$10 -
20 AIR HANDLER (DOES NOT include ducting)
- OR < 10,000CFM
X
$12 -
21 AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19'
22 EVAPORATIVE COOLERS
-
44 X
$10
23 TYPE I HOOD
_
X
24 TYPE II HOOD
-
X
$10 -
25 HEAT PUMA/AIR CONDITIONER
0-3 TON
X
$12
26 AIR CONDITIONER
3-15 TON
X
$20 -
27 AIR CONDITIONER-
15-30 TON
X
$25
28 AIR CONDITIONER
30-50 TON
X
$35
29 AIR CONDITIONER
+50 TON
X
$60 -
30 LPG STORAGE TANK
-
X
S10
31 WOOD OR PELLET STOVEANSERT
-
x
$10 -
32 WOOD STOVE - FREE STANDING
_
X
$25 -
SENT
MCK ❑ n
SUBTOTAL:
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
NKCARD NUMBEIL-
THOWZED SIGNATURE:
EXPIRES:
DOT
'y a Or +/'
Stine
Ivey
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
Plumbing Permit Application
PLTTMRTN(_ VTY'MTVVC
1
2
3
4
5
DESCRIPTION
TOILETS
URINALS
TUBS
SHOWERS (PER TRAP)
SINKS
DETAILS
WATER CLOSET, BIDETS
BATH, STALL, ON-SITE BUILT
LAVS/BASINS, BAR, FLOOR, KITCHEN,
I# OF UNITS
X
X
X
X
X
COST
EQUALS
. AMOLIIVT
$6
$6
_
_
$6
_
$6
LAUNDRY, UTILITY, JANITOR, PHOTO; X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
1
6
7
8
9
DISHWASHER �
CLOTHES WASHER
GARBAGE DISPOSAL
WATER
X
X
X
$6
_
$6
_
$6
10
11
SOFTENER
ELECT. HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS, SEE MECHANICAL
AREA,.CASE, COIL, TRENCH, CONDENSATE
X
X
X
$6
$6
$6
_
12
13
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN
INSTALLATION, ALTERATION, REPAIR,
X
... _- -WA
M, VENT,'PLUMBING
REVERSAL
REVERSALS —
X
__
_....
j „
l (�
14
15
SEWAGE EJECTOR
WATER USING DEVICE
GRINDER, SUMP PUMP
ICE AND/OR COFFEE MAKER, HOSE BIB,
X
_
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
t Z
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
17
18 INTERCEPTORS
SPRINKLER SYSTEM
GREASE TRAP, SAND TRAP, CHEMICAL
Q
X
$25
HOLDING TANK
Q
X
$6
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
f
20
MISC. PLUMBING FIXTURE
O
X
66
PAYMENT
SUBTOTAL:
CI IECK Q 0 L Y_ i
PLUS PROCESSING FEE:
TOTAL PERMIT FEE DUE:
EXPIRES:
ID NUMBEIL-
ZED SIGNATURE:
Site Information
Site Address: 620 S SHELLEY LAKE LN
VERADALE, WA 99037
Parcel Number: 45242.1310
Subdivision:
Block: 3 Lot: 10
Zoning: UR -3 Urban Residential 3.5
Owner: MADDEN, KEVIN M
Address: 1214 S PROGRESS RD
VERADALE, WA 99037
Building Inspector: BOBBY STONE
Water Dist:
Project Information
Project Number: 03004405 Inv: 1 Issue Date: 6/25/2003
Permit Use: SEWER CONNECTION - SHELLEY LAKE PUD
Applicant: MADDEN, KEVIN M
1214 S PROGRESS RD
VERADALE, WA 99037
Contact: MADDEN, KEVIN M
1214 S PROGRESS RD
VERADALE, WA 99037
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Phone: (509) 927-7526
Phone: (509) 927-7526
Rear:
Permits
Sewer Connection Permit contractor: FOLSOM EXCAVATING INC License #: FOLSOEI994DO
SEWER CONNECTION 1 $85.00 PROCESSINGFEE $15.00
Total Permit Fee: $100.00
FOR SEWER INSPECTIONS CALL (509)477-3604 UTILITIES 8:30-5:0'0 PM MONDAY THRU FRIDAY
Call for inspection prior to cover. ONE WORKING DAY NOTICE REQUIRJ
Contractor or applicant is to field locate and confirm the elevation"and position`a
Sewer stubs are to be checked prior to connection to ensure that they have accel
Sewer lines should be constructed to allow for gravity flow from the lowest leve
This permit must be presented to the job site inspector for verification. To locat
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRION TO -ANY EXCAVAT:
NOTIFIED. CALL BEFORE YOU DIG AT LEAST ' -2 WORKING DAYS IN)
Spokane County Code requires the installer comply ",vitli;allrequirements of the
those related to trench safety.
Payment Summary '
Total Fees 6mountPaid AmountOwing Tran Date
$100.00 $100.00 $0.00 6/25/2003
Processed By: BURRIS, ROBIN
Printed By: WENDEL, GLORIA Page 1 of 1
sewer stub prior to any other excavation.
ible grade and are clear and unobstructed to the main sewer.
)f the structure.
Buried cables, gas piping, water lines, etc.
N xIM "CALL BEFORE YOU DIG" CENTER BE
)V CE,
(509)456-8000.
Fashington"State Dept of Labor and Industries, including
Receipt # Payment Amt
4029 $100.00
PERMIT