2005, 06-24 Permit App: 05002178 RemodelProject Number: 05002178 Inv: I Application Date: 6/24/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proiect Information •
Permit Use: PARTIAL BASEMENT FINISH - 648 SQ FT Contact: HARRISON, RAWLEY & HELEN
Address: 2127 N MONROE
C - S - Z: SPOKANE, WA 99205
Setbacks: Front Left: Right: Rear: Phone: (509) 325-2127
Group Name:
Site Information: Project Name:
Plat Key: 000000 Name: GRANGE District: Nort
Parcel Number: 45171.0204 Block: Lot:
SiteAddress: 10405 E SINTO AVE Owner: Name: HARRISON, RAWLEY & HELEN
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: .,284.00 Acres Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Address: 2127 N MONROE
SPOKANE, WA 99205
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
This Application:
Description Grp Type Notes Sg Ft Valuation
BASEMENT R R-3 VB 648 $3,240.00
Totals: 648 $3,240.00
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Total Project:
Sq Ft Valuation
648 $3,240.00
648 $3,240.00
Fee Amount
$97.25
$4.50
$38.90
$140.65
Operator: DMD Printed By: DMD Print Date: 6/24/2005
Project Number: 05002178 Inv: I I Application Date: 6/24/2005 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Item Description
VENTILATING FANS
Contractor: OWNER
Mechanical Permit
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc Fee Amount
1 NUMBER OF $10.00
Permit Total Fees: $10.00
Plumbing Permit
Firm: OWNER
Phone: (000) 000-0000
Item Description
Units
Unit Desc
Fee Amount
TOILETSBIDETS
1
NUMBER OF
$6.00
TUBS
1
NUMBER OF
$6.00
GARBAGE DISPOSAL
1
NUMBER OF
$6.00
FLOOR DRAINS
1
NUMBER OF
$6.00., �
I_.r, ,
Permit Total Fees:
Notes:
Payment Summa
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $140.65 $140.65 $0.00 $140.65
Mechanical Permit $10.00 $10.00 $0.00 $10.00
Plumbing Permit $24.00 $24.00 $0.00 $24.00
$174.65 $174.65 $0.00
Disclaimer: c�
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: DMD Printed By: DMD Print Date: 6/24/2005
,Street Address: 16
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 p
Assessor's Tax Parcel Numbers):
1:57-/1/1D
Legal Description: 6' r a 0- jj-'A 2 Z.V s6
PERMIT DESCRIPTION:
Building Permit
❑ Relocation
❑ Change in Use ❑ Grading
❑ Tenant Improvement ❑ Fire Safety
❑ Manufactured Home
❑ Other
I OWNER/APPLICANT INFORMATION I
Owner: y -
Phone:
Address:
City
❑ Applicant:
Fawi41,,w
Phone: _
r, Address:
Fax:
S to i 125Code city state Zip Code
--07Contractor: ll
Phone: Fax:
Address:
Iii
City State Zip Code
WA State Contractor License #:
Spokane Valley Bus. Liscense M.
❑ Architect:
Phone:
Address:
City
Contact:
Contact:
PERMITIBUILDING INFORMATION
Fax:
State Zip Code
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOROO SQ. FTG:
2 FLOOR SQ. FTG:
UNFiN BAS MEN SQ. FTG:
FINISHED BASEMENTS . F G•
GARAGE SQ. FTG:
DECK/COV. PATO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEA .SQURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER ORO -SITE SEPTIC
SYSTEM?
MANUFACTURED HOME I
Width: Length: Year: Pit Set:
Manufacturer:
Previous Address:
Proposed Use: _
Fire Sprinkler.
Tent:
Valuation:
RELOCATION
FIRE SAFETY
# of Heads: Fire Alarm:
Fireworks Display: Blasting:
Above/Underground Storage Tank Size:
Paint Booth:
Date/Time:
I WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Inspector:
Address:
Phone: Fax:
city State
Phone: Fax:
city
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE
Firm Name:
Inspector(s):
❑ REINFORCEMENT
Phone:
State
Fax:
Zip
❑ 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 prope y owner.
Print Name P/��/i6J_�_4&TA Signature, �iL_u
Method of Payment. (Faxed permit applications will only be accepted with major bankcard)
❑ CashCIV heck
1P
Bankcard #:
Authorized Signature:
❑ Mastercard VISA
Expires:
VIN#:
❑ Other
Project
Owner.
PLUMBING PERMIT APPLICATION Community Development Department
Building Division
Phone: (509) 688-0036; FAX:; (509) 688-0037 11707 E. Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
q6 s bib Permit Use:
Mailing Address: //14d taLV=
Contractor.
ff
Phone (Daytime Contact): '-4/
67 67 e7
License #:
State . Zip Code
Phone #:
Mailing Address:
City State Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF UNITS
X
COST .
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
-
2
URINALS
X
$6.00
-
3
TUBS
X
$6.00
-
4
SHOWERS PER TRAP
BATH STALL, ONSITE BUILT
X
$6.OD
-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.0D
=
6
DISHWASHER
X
$6.00
-
7
CLOTHES WASHER
X
$6.00
-
6
GARBAGE DISPOSAL
X
$6.OD
-
9
WATER SOFTENER
X
$6.00
-
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.DO
-
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
-
13
FOUNTAINS, DRINKING
X
$6.0D
-
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.OD
-
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6. DO
-
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6 -DO
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS BOILERS
X
$6.00
-
16
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
-
19
MEDICAL GAS r outlet)
NITROUS, OXYGEN
X
$6.0D
-
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
-
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH HECK VISA ❑ MASTERCARD
DATE EXPIRES:
SUBTOTAL
PROCESSING FEE
0
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION
p Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Project Address:
Owner:
Mailing Address:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
City State Zip Code
Contractor: License M Phone #:
Mailing Address:
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
$12.00 -
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00 -
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 SEC min. AFUE rating)
Equal to or less than 400,000
X
$50.00 -
6
USED APPLIANCE SEC min. AFUE raliin
More than 400,000
X
$100.00 -
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00 -
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00 =
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00 -
10
BOILERIREFRIGERATION
1,001 - 1,750M BTU
X
$35.00 =
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00 -
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00 =
RANGE
X
$10.00 -
DRYER
X
$10.00
r14
FUEL BURNING WATER HEATER
X
$10.00
MISC. FUEL BURNING APPLIANCE
X
$10.00 -
17
GAS PIPING each outlet
X
$1.00 =
16
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
$15.00 =
22
EVAPORATIVE COOLERS
X
$10.00 =
23
TYPE I HOOD
X 1
$50.00 =
24
TYPE II HOOD
X
$10.00 =
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00 =
26
AIR CONDITIONER
3-15 TON
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
$60.00 =
30
LPG STORAGE TANK
X
$10.00 =
31
WOOD OR PELLET STOVE/INSERT
X
$10.00 =
32
WOOD STOVE - FREE STANDING
X
$25.00 =
33
REPAIR & ADDITIONS
X
$15.00 =
34
VENTILATION SYSTEMS'
X
$12.00 =
35
VENTILATION MECHANICAL EXHAUST
X
$12.00 =
36
INCINERATOR - RESIDENCE
X
$19.00 =
37
INCINERATOR - COMMERCIAL
X
$22.00 =
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MC
CARD#:
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
As SMOKE
DETECTOR
IF
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rx-
smOu
EMERGENCY E SS REOUIREMEN'
FROM SLEEPING ROOMS DETECTOR
1) NET CLEAR OPENING: 5.7 SOU n
GRADE FLOOR OPENING (MA1144•) 5.0 SQWc
2)NET CLEAR OPENING HEIGHT 241NCHE
3) NET CLEAR OPENING WOTH 2O INCHES ��� +T
4) MAX FINISHED SILL HEIGHT 44' ABOVE - r +�-RFSE , piNS MUST 'S� -KEPT
5) EMERGENCY ESCAPE & RESCUE OPENING SHALL . ON THE �
\ OPERATIONAL FROM THE INSIDE OF THE ROOM "THOJOB
TE
T E USE OF KEYS OR TOOLS r
sMolmYA
lij e e
PUA
oMs► CE fi
1MIQ1 WY MR ALTEU NS.
) AEQUNIIM(; A POW OCCO. ONE OR M101E'
SLiEP111110 MMEAMORCREAIMOEWTIN SMOKE ALARMS SHALL SE INTERC(UN-
DMLIM. TIE DWM M IMT SIMM SE PROVIDED NECTED AND NANO WdMED IN SUCH A
I MIME MAVAW IEOASDEOIllt;1lbFORNEW MANNER THAT THE ACTIVATION OF ONE
MILWM. ALARM WILL ACTIVATE ALL ALARMS.
(BEDROOMS, AREAS APPROACHING
BEDROOMS. VAULTED CEILING
WITH RISE OF 24' A ON EACH FLOOR).