2003, 12-23 Permit: BLD-03-03328 ResidenceSpOkane
.00,0Valley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
COST OF PROJECT
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
CURRENT PROPERTY USE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
ROOF DRAINS
WATER USING DEVICE
CROSS CONNECTION DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
RANGE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
AIR CONDITIONER 15 - 30 TON
f r
NEW SINGLE FAMILY RESIDENTIAL PERMIT
sfr
171172
19
57 X 62
140430
1
2
25
90
13
13
r-3
5-n
0
13862
RESIDENCE
no
no
2
2
1
5
1
1
1
0
1
3
2
1
1
1
1
1
4
3
1
1
Permit #:
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
ROOF DRAINS
WATER USING DEVICE
CROSS CONNECTION DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
RANGE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
AIR CONDITIONER 15 - 30 TON
Total Calculated:
Deposits/Receipts:
Total Due:
BLD -03-03328
558.78
1,396.95
4.50
12.00
12.00
6.00
30.00
6.00
6.00
6.00
6.00
18.00
12.00
15.00
10.00
10.00
10.00
10.00
4.00
30.00
25.00
2,188.23
2,188.23
0.00
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 . ordinances.
Ownership of resulting development rights granted by any issu l-pemait inure to the property owner
Jerry ue,
Print dame
Staff Initials
Sign-ture
THIS IS NOT A RECEIPT
Date