2004, 05-21 Permit App: BLD-04-04418 ResidenceCITY 11F
Spokane
. ,00Vatley
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
Application #:
Job Address: 631 S SHELLEY LAKE LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
WELLS, FRANK D & LAURA A
HAWKINS CONSTRUCTION
13718E 41ST AVE
SPOKANE, WA 99206-9332
HAWKINS CONSTRUCTION CO
13718E 41ST AVE
SPOKANE WA 99206-9332
Lot: Blk: Parcel No:
Phone: (509) 922-1047
Phone:
Lic No:
(509) 922-1047
HAW KI CC044 KN
Applied:
Issued:
Expires:
BLD -04-04418
05/21/2004
11/17/2004
Zoning:
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT 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
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTENER
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 II HOOD
AIR CONDITIONER 3 - 15 TON
sfr
231933
26
60 X 67
1
4
20
5
5
r-3
5-n
1
70 X 110
no
no
4
3
6
1
1
1
1
1
1
3
1
2
1
1
4
5
1
1
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTENER
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
AIR CONDITIONER 3 - 15 TON
Total Calculated:
Deposits/Receipts:
CITY OF SPOKANE VALLEY'
APPROVED FOR SUBMITTAL.
Initials / Date P
Building /
tal Due:
693.18
1,732.95
4.50
24.00
18.00
36.00
6.00
6.00
6.00
6.00
6.00
6.00
18.00
19.00
20.00
10.00
10.00
4.00
50.00
20.00
2,695.63
0.00
STiol+anC 2,695.63
Valley
EVIEWED FOR CODE COMPLIANCE
SPAKINE VALLEY BILDINDIVISION
Planning`j I h[c/ ,/ co_ t JCS
Public Works
THIS IS NOT A RECEIPT
••••,\.,
*lane
doonalley
-s
}S , / IPlor
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address:
131 5I4,Q,Qtil
Assessor's Tax Parcel Number(s): !�
Legal Description: t7L /� B to -K Z
PERMIT DESCRIPTION:
,k Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
0 Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: C44 -1 -
Phone: qcz S"5o 7�
Ad res '2c 1
Fax:
t>rivee
City
State
Zip Code
0 Applicant: J twv►. a L,' AS
Phone: 92Z toq 7 Fa)s:
Addr ss: ,1,37(8 Ctl
SL) 471
City State Zip Code
Architect: 60
Phone: Cbz -393 -/.32 Fax:
Address: c Z0 o, "lo 5/'
-i37
Zip Code
❑ Contractor: 14. 4 / tL1ij$" Am -y u.i70.%) C 0
Phone: 9 ZZ k (47 Fax: q Z Z-3( C
Addr! s: . 131/& 41 sr-
Lam-, gyZdz'
City
State Zip Code
WA State Contractor License #:
C\ n)
City
Contact:
State
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK /
DIMENSIONS X 9,7
# OF STORIES: /
MAIN FLOOR TQ-SQFTG:
1-
2"" FLOOR SQ. FTG: UNFIN
BASEMENT SQ. FTG:
/La
FINISHED BAS (� EN SQ. FTG:
GARAGE SQ. FTG: 5/ '
DECK/COV. PATIO SQ, FTG:
OCCUPANCY GROUP:
CONSTN TYPE:
HEAT SOURCE:
# OF BEDROOMS: 44
TOTAL HABIT L E SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON- ITE SEPTIC
SYSTEM? -UV2.--
MANUFACTURED' HOME
Width:
Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth:
Tent: Fireworks Display: Blasting: Date/Time:
Valuation: Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
❑ REINFORCEMENT
Phone:
Inspector(s):
Fax:
❑ 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)
❑ Cash ❑ Check ❑ Mastercard El VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
*lane
doi,Valley
(,3t sUcti
Project Address:
Owner:
Mailing Address:
MECHANICAL PERMIT APPLICATION
City 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
Permit Use:
Phone (Daytime Contact):
Contractor: (3)1/4',t -t-- C�
Mai ing Address:
City
License #: Phone #:
State
Zip Code
City "'
State
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
1
X
$19.00
=
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
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
9
BOILER/REFRIGERATION
501 -1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
1,
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)
t
X
$1.00
=
18
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE Il HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
1
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
$80.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
32
WOOD STOVE - FREE STANDING
X
$25.00
=
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:
Zip Code
Snpolane
4#Valley
(e3i sG�.t�,L�,C�
Owner.
Project Address:
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuitdingDivision
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 (Daytime Contact):
Mailing Address:
Contractor: 41aiV
Mailing Address: "
Zip Code
License #:
City
State
Phone #:
Zip Code
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
*OF
UNITS
X
COST
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
—1
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
/I
�J
X
$6.00
=
6
DISHWASHER
1
X
$6.00
=
7
CLOTHES WASHER
/
X
$6.00
=
8
GARBAGE DISPOSAL
I
/
X
$6.00
=
9
WATER SOFTENER
1
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
i
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
INSTALLATION, ALTERATION,i
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
,3
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
$6.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
WELLS, FRANK D & LAURA A
207 SEA PINES DR
Min
5242.1308?
15242.1309
PAPILLION !NE 68133
Citri (P.)CJFu'e(Tt4)...
Friday, May 21, 2004 04:35 PM
• PLUS - Perrmt_. Larid ...
I f I
R 4;3 Pit
6,31 41_,A14,1
ccit-uL4
1 Zo-o
f -m -,,AL 4 ut-out--
I • -
ADDRESS (1:?--)/ /1(
- ZONE
ROAD WIDT11-1, ,
FRONT -ALFLANKING
COMMENTS
REVIEWED BY
This site plan Is being submIlaid ts, Ohs sews 01
obtaMing a building porn* and Is a bus and eiallaid
representation of the proposal. MI Mow popelly
lines/dimensions, curb lines, sawelwilla old itlialleents
have been identified. Also 1n4&psNq stosIleads,
steep slept as collical amis.
bodies
Siowid•
Dale:
I if4-4-A,,
M„00,L.
• 3„00,.L0.2ZN N 1
" • n