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2004, 08-06 Permit App: BLD-04-07276 Remodel"ft, Spo Ual el Y 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 Street Address: REQUIRED SITE INFORMATION , Assessor's Tax Parcel Number(s): Legal Description: PERMIT DESCRIPTION: Building Permit 0 Relocation Tl ❑ Change in Use ❑ Grading 0 Manufactured Home D Tenant Improvement ❑ Fire Safety D Other OWNER/APPLICANT INFORMATION ❑ Owner: cc, LQ CV) m❑ Phone: 6' LI '4"2 -Tax: Address: 9 M Lcc City Applicant: O U.) i \ . Phone: Fax: Address: State Zip Code City State Zip Code ❑ Contractor: b ❑ Architect: Phone: Fax: Phone: Fax: Address: Address City State Zip Code City - State WA State Contractor License #: Contact: Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK C C_t_ la, J DIMENSIONS: te_4 ©k # OF STORIE: MAIN FLOOR, 10 SFIG: 1, 1 - 2"" FLOOR SQ. FT • %JNFIN BASEMEN2�yFTG: f-( Cr FINISHED BASEMENT SQ. FTG: GARAGE SQ. FT : i`jJ k DECKIGOV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRVCTION b l' DP GHEAAA sSR` D D 'C1 # OF BEDROOMS: 4 TOTAL I-IABITABLJPACE: IMPERVIOUS SURFACE AREA: COST QF PRO3EcT: a1 t SO 0 30% SLOPES ON PROPERTY: SYSTEM? O I Q. 1 L MANUFACTURED HOME Width; Manufacturer: Length: Year: Pit Set: RELOCATION Previous Address: Proposed Use: l FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint. Booth: Tent Fireworks Dieplay: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Inspector: Address: Phone: Fax: City Phone: State Fax: Zip City State Zip SPECIAL INSPECTIONS ❑ BOLTING Firm Name: 0 CONCRETE 0 REINFORCEMENT Phone:. Inspector(s): 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 ta 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:pbkane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Fax: 0 WELDING 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 0 Mastercard Bankcard #: Authorized Signature: 0 VISA ❑ Other Expires: VIN#: Slie'kat% Project Address: l 1 3 E 3.1 \� Owner: N\Mailing Address: 1`r 'r it, Zia Contractor: Mailing Address. PLUMBING 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: MD D % f(V ` `J one (Daytime Contact)g26'' q ti O �)3(11 v)61 -L State Zip Code ls` r2___v-0-L�/Lic�nse #: Phone #: 2 V `_ City State BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Co.e TOTAL OF WORK SOF UNI'S X COST • AMOUNT DESCRIPTION WATER CLOSET, BIDETS X $6.00 - 1 TOILETS X 56.00 = 2 URINALS X 56.00 = 3 TUBS TRAP) BATH, STALL, ONSITE BUILT X 56.00 4 5 SHOWERS (PER SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT 1 X $6.00 = X 56.00 = 6 DISHWASHER WASHER X 56.00 = 7 CLOTHES DISPOSAL X 56.00 8 GARBAGE X 56.00 = 9 WATER SOFTENER HOT WATER TANK NOTE IF GAS, SEE MECHANICAL X 56.00 = 10 11 ELECTRIC FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 56.00 = DRAINS X 56.00 = 12 ROOF DRAINS/OVERFLOW DRINKING X 56.00 13 14 FOUNTAINS, WATER PIPING/DRAIN-IN WASTE, REVERSAL INSTALLATION, ALTERATION,/ REPAIR, REVERSALS X 56.00 = VENT, PLUMBING, EJECTOR GRINDER, SUMP PUMP X 56.00 = 15 16 SEWAGE WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X 56.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR VATS, TANKS, BOILERS X 56.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56.00 = GAS (per outlet) NITROUS, OXYGEN X $6.00 = 19 MEDICAL PLUMBING FIXTURE r^.7T� V X $6.00 = 20 MISCELLANEOUS METHOD OF PAYME• Q CASH CHECK -...1%Ne. Ft 4`-1 ❑ VISA ID MASTERCARD cvotoce. SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Co.e iii .0y A00ijFSS '?OAO Olv C04i 14 -'x M&A, r fieVIE !Ifetv Obtam, P'On is h buildin-eIng sub tO resen,,,. "lifted ineslj�f ton Of the and the OX menslo ,..,the PtIrpoft ur plopos true of and be Oclie b an id tifect. line s a - Ali known erect of ter, A tures pr and ea ?P"jf Signed. Ct ante ------ are Wetlands, critical ave: area.. .4--A I ('�J E TDRAWING NUMBER 1440 4!!� 44,_A