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2003, 11-06 Permit App: BLD-03-02993 ResidenceSpokane Malley 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: 626 S SHELLEY LAKE LN SPOKANE VALLEY WA 99037 Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS Subdivision: Owner: Applicant: Address: Contractor: Address: SHELLEY LAKE PUD MADDEN, KEVIN M MADDEN CONSTRUCTION 10601 E NIXON LN SPOKANE VALLEY, WA 99206 KEVIN MADDEN CONSTRUCTION 10601 E NIXON LN SPOKANE WA 99206-3794 Application #: BLD -03-02993 Applied: Issued: Expires: Lot: 11 Blk: 3 Parcel No: 45242.1311 Zoning: Phone: (509) 924-6497 Phone: Lic No: (509) 927-7526 KEVINMC146J5 11/06/2003 05/04/2004 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 SERVED BY SEPTIC SYSTEM WELLS LOCATED ON PROPERTY TOILETS TUBS SHOWERS (PER TRAP) SINKS DISHWASHER CLOTHES WASHER GARBAGE DISPOSAL FLOOR DRAINS WATER PIPING/DRAIN-IN WASTE WATER USING DEVICE FUEL BURNING APPL <= 100,000 GAS LOG, INSERT, FIREPLACE DRYER FUEL BURNING WATER HEATER GAS PIPING (ea. OUTLET) VENTILATING FANS TYPE 11 HOOD sfr 144048 29 46 X 33 2 3 40 25 5 5 r-3 5-w 1 no no 3 3 1 5 1 1 1 1 1 2 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 PIPING/DRAIN-IN WASTE 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: Total Due: CITY OF SPOKANE VALLEY APPROVED FOR SUBMITTAL Initials / Date Building Planning Or S REVI /li 0 , 498.30 1,245.75 4.50 18.00 18.00 6.00 30.00 6.00 6.00 6.00 6.00 6.00 12.00 15.00 10.00 10.00 10.00 3.00 40.00 1,950.55 0.00 1,950.55 Valley WED FOR CODE COMPLIANCE ANE VALj.EY QUILDING,,DIVISION 1Q,{.c../ ' Let caArieoef597- THIS IS NOT A RECEIPT CITY 40,17alley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 Fast Sprague Ave Ste 106 Spokane Valley, WA 99206..., Phone: (509)688-0036 Fax: (509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: ASSESSOR'S TAX PARCEL LEGAL DISCRIPTION: 2� -e 61� UMBER(S) : 7a40,2 /3fi eieLrA 91u -e- etc .P. PERMIT DESCRIPTION: /Yew h oni C©.Ii5e4-'44.-c- 6 oar WBI TDINc .P-EIU%II.T CFREEQCATJ&N CI CHANGE IN USE ..CI GRADING .D MANUFACTURED HOME ®-SIGN CI -TENANT 0-0tHER... . OWNER / APPLICANT INFORMATION 0 OWNER: X-" Mallet( PHONE: ADDRESS: ® APPLICANT: FAX: PHONE: 92-'1-6 '77 FAX: CITY,STATE, ZIP CONTRACTOR: 4.-a i/ W Madded CQrifj't , CO • ADDRESS: /eli 0/ )2<. - Uc A ARCHITECT: n r 't v PHONE: 9.27 1,a- 6 FAX: �l i �[ , PHONE: ADDRESS: I 14 Cit 0i...5,0062 -de- .Vt9//f.,.,,fADDRESS: 11 CITY,. STATE, ZIP �7/�(p CITY, STATE, ZIP WA ST CONTRACTOR LICENSE # A -/i , /'? e (C( 1C JS' , STATE, ZIP FAX: CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT:(f,✓kj'Gkd/f BUILDING HEIGHT ATO 2 EAK• 0 cz BUILDING DIMENSIONSbr:' 'NUMBER OF STORIES: / NUMBER of BEDROOMS: �J FLANKING SETBACK: 5' FRONT SETBACK: REAR SETBACK: -' 5® LEFT SETBACK: RIGHT SETBACK: b ---'t2 o 30% SLOPES ON PROPERTY: Al O-CCUPANCY GROUP:.,S'/'/5/E' par - 9. ` CONSTRUCTION TYPE: f i✓� Ciin� STRUCTURES ON PROPERTY: »d4 CRITICAL AREAS: CURRENT PROPERTY SIZE: --/Q -,c."(.7) CURRENT PROPERTY USE: a�ri4, dc� Ltc't CURRENT SEPTIC USE: CURRENT WELL USE: /74. IMPERVIOUS SURFACE AREA: t MAIN FLOOR SQ FT: loft9 2ND FLOOR SQ FT:- i 4. tp UNFIN BASEMENT: "' FINISHED BASEMENT: /Yoye GARAGE: Iffr COVERED DECK: /OM' DECK: />/ori 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: ADDRESS:. . PHONE: FAX: CITY, STATE, ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY, STATE, ZIP SPECIAL INSPECTIONS 13 BOLTING ®CONCRETE .0 REINFORCEMENT ® WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: CI YES 0 NO IF YES: 0 COUNTY 0 CITY - IS PUBLIC WATER AVAILABLE: 0 YES 0 NO IF. YES, WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES a NO IS THE PROPERTY LOCATED WITHINASA: 0 YES NO • PSSA: 0 YES 0 NO DATE: tI STAFF: METHOD OF PAYMENT: 0 CASH CHECK BANKCARD 0; EXP/RES. V/NAS AUTHOR/ZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD Spokane .0.0Valley Plumbing Permit Application 11707 East Spratte Avenue, Suite 106 509-688-0036 Phone 509-688-0037 - Fax Spokane Valley, WA 99206 PROJECTI JJ ADDRESS: Ip� S'/ eLLe� Lie a NI YP." PERMIT USE: rye CD.,r6,t, DETAILS OWNER: //e1 iJ /dam PHONE (Daytime Contact): COST MAILING ADDRESS: Si/ti 7fOq .less' JPd C'I'f/ Of' S'pe g 1�// - 99037 AMOUNT (strOt) (cit/state) (ZIP) TOILETS CONTRACTOR: [ipt`m }y,`��""�� . _ � /,( _� ' ,/ Cis ',/ LICENSE it: YE1,lll tit /y1 jr /, X MAILING ADD ESS: 31114 feolre55 U C t, o e Sp Cka4W8 PHONE If. 97-7_<„1-6 Cei ...2/7-70,0 V4I/' kit- 9 `9D 37 (stree (city/tate) (ZIP) ' PLUMBING FIXTURES 3THOD 0 CASH LTE: NKCARD NUMBER THORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS Q X $6 - !0� 3 TUBS X $6 - ja, 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT / X $6 6 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 3 1.,04-). 4,44ppi. / Kt ;4.4,u/ X $6 - q OC�'F 6 DISHWASHER l X $6 - 7 CLOTHES WASHER / X $6 - 8 GARBAGE DISPOSAL J X $6 - 9 WATER SOFTENER 0 X $6 - 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6 - -* 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE / X $6 - 6 12 FOUNTAINS, DRINKING 0 X $6 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSALear, INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 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 a. be)); b X $6 - /; 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS nn X $6 17 SPRINKLER SYSTEM /Y4 X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK //G//fi X - 19 MEDICAL GAS per outlet NITROUS, OXYGEN /1(4. X $6 - 20 MISC. PLUMBING FIXTURE //14,1 - X $6 - PAYMENT : CHECK mom • VISA"R1'asv .__ - -- _ SUBTOTAL: 't0 6,CC PLUS PROCESSING FEE: - $35.00 I ■ TOTAL PERMIT FEE DUE: !34 a LTE: NKCARD NUMBER THORIZED SIGNATURE: 1 Site Information Project Information Site Address: 626 S SHELLEY LAKE LN VERADALE, WA 99037 Parcel Number: 45242.1311 Subdivision: Block: 3 Lot: 11 Zoning: UNK Unknown Owner: MADDEN, KEVIN M Address: 1214 S PROGRESS RD SPOKANE VALLEY, WA 99037 Building Inspector: BOBBY STONE Water Dist: Project Number: 03007916 Inv: 1 Issue Date: 10/31/2003 Permit Use: SEWER CONNECTION - SHELLEY LAKE PUD Applicant: KEVIN MADDEN CONSTRUCTION S. 1214 PROGRESS RD VERADALE, WA 99037 Phone: (509)927-7526 Contact: KEVIN MADDEN CONSTRUCTION S. 1214 PROGRESS RD VERADALE, WA 99037 Phone: (509) 927-7526 Setbacks - Front: Left: Right: Rear: Group Name: Project Name: Permits Sewer Connection Permit Contractor: KEVIN MADDEN CONSTRUCTION License #: KEVINMC146J5 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 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 !BE "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. $15.00 $100.00 Total Fees AmountPaid AmountOwing $100.00 $100.00 $0.00 Tran Date 10/31/2003 Processed By: BURRIS, ROBIN Printed By: WENDEL, GLORIA Page 1 of 1 Receipt # 6986 Payment And $100.00 PERMIT 1 1 t* -C1)40 • PLANNING DEPT. APPROVED TE: 6061,5g J. oca,-EI • 1.1 MA 4"1 CI4AMAti X644. PeOPCR71 L//:/e. Zei-il-Sik.3 6.24. gelle7 40..kedpiv eNrd 1 9A ell ose-mc.-44r 7=0" r r &,L,s 54E l i y CA-eF LAI PLANNING DEPT. APPROVED