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2004, 05-17 Permit App: BLD-04-04382 Duplex "°1\"'" 4.0001VA*7 PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 906 Spokane Valley, WA 99206 Phone; 509 888-0036 Fax: 509 688-0037 REQUIRED SITE INFORMATION STREET ADDRESS:_1212jU r. .VES✓t Ø4g ASSESSOR'S TAX PARCEL NUMBER(S): 1 LEGAL DISCRIPI'ION: L)' '3 S 1 I J 03 PERMIT DESCRIPTION: "lett, burl RiTJLDING PERMIT D CHANGE IN USE CI.GRADING a MANUFACTURED HO1s(E DRELOCATION DSIGN DTENANT OWNER I APPLICANT INFORMATION OWNER; 1 'i -�v±'� :tjl Z�;�( OAT,/ ® APPLICANT: PHONE: (L2q-Y)`%I,r E-I,AA FAX: !2&- SO / ! j PHONE: FAX: ADDRESS: /S-.3 2/ �44s S 3'o --3kt�tt a I/� ADDRESS: CI7Y,STATE,ZIP C ,- '7 • CITY,STATE,ZIP 000NTRACTOR: ARCHITECT:_ - PHONE: FAX: PHONE: FAX: _. ADDRESS: ADDRESS: CITY„STATE.ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: 7C,1 to:›0,, 9 . 30%SLOPES ON PROPERTY:A.30 MAIN FLOOR SQ FI`:2= BUILDING HEIGHT TO PEAK: 5Q / C/CCUPANCY GROUP:_ 2ND FLOOR SQ FT: BUILDING DIMENSIONS: 5:1IX PC CONSTRUCTION TYPE: UNFIN BASEMENT: NUMBER OF STORIES: I STRUCTURES ON PROPERTY: ki0 FINISHED BASEMENT: NUMBER of BEDROOMS; CRITICAL AREAS: Ai!) • GARAGE: DATE: STAFF: -- - METHYOD OF PAYMENT; O 0 D r CI .001.111 kkK= bfj• CASH CHECK -�- BANKC4RD8; - EXPIRES` _ _ , VIN# AUTHORIZED SIGNATURE: SO/20'd V6089E6 01 ad tiO:LT 200E OE d3S 11707 East Sprague Avenue,Suite 106 509-68B-0036'-Phone p�e Spokane Valley,WA 99206 509-688-0037-Pax VallerY r Plumbing Permit Application - PROJECT PERMIT ADDRESS: q /7 _itid Vkt6l 4 L USE . OWNER: ' : s Y1 41 . , PHONE(Daytime Contact): MAILING ADDRESS: /5-32f E E. S5: S •1w 'lJ '-ife , t.1,, `,1 )3, (street) (city/#ate) (ZIP) CONTRACTORLICENSE I: ti MAILING ADDRESS: PHONE 1: (street) (city/state) (Zl'). ' • _ PLUMBING FIXTURES DESCRIPTION DETAILS d OFWThTS X COST EQUALS AMOUNT ii TOILETS WATER CLOSET,BTDEIS M� X $6 E# •URINALS _ - '� TUBS n SHOWERS(PER TRAP) BATH,STALL,ON-SITS BUILT X SINKS t.. VS/SASINS,BAR,FLOOR,IQix i-r , I ' LAUNDRY,U'IILTIY,JANITOR,PHOTO,X- X - RAY,FOOD,PREP/CULINARY/MEAT in DISHWASHER X LiIRCLOTHES WASHER IIIWAIOIMMI i6 a GARBAGE DISPOSAL, X WATER SOFTENER X 1D ELECT HOT WATER TANK NOTE IF GAS,SEE MfiCHANICAL X ll u FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE 111 FOUNTAIN$,aRINIUNG ' WATER PIPING/DRAIN-LN INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMUING REVERSALS. REVERSAL in SEWAGE EJECTOR GRINDER,SUMP PUMP WATER USING DEVICE ICE AND/OR COFFEE MALGIR,HOSE BIB, STEAMER,PROOF:,CARSONATOR, / -7 SWAMP COOLER ii02 X K ICROSS CONNECTION DEVICE VACUUM BREAKER,CHECKVALVE,AND R.P,BF.D.FOR VATS,TANKS,BOILERS X MEDICAL SYSTEM X $25 �� INTERCEPTORS GREASE TRAP.SAND TRAP.CHEMICAL X $ HOLDING TANK MEDICCAL GAS per outlet NITROUS,OXYGEN X S6 .. 20 MISC.PLUMBING FIXTURE X S6 - HOD OF PAYMENT SUBTOTAL: /o.oa i -7d PLUS PROCESSING FEE: $35.00 LSI ❑ cHE c ❑ MEM 0 _ - • TOTAL PERMIT FEE DUE: 1 5-5--‘C r) . EES :CARD NUMBER - ORIZED SIGNATURE; —•, -----` SO/VO'd P6089E6 01 eld T :LS €00Z OZ d3S • ** S0'39bd 10101 ** Sraan<S411111. 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone Spokane Valley,WA 99206 509-688-0037-Fax 4000 valley •Mechanical Permit Application. PROJECT PERMIT ADDRESS: g r7 /U . ,..t& /n c!"` T"'- USE: OWNER 0 slit sad . C- {• : PHONE(Day time Contact); MAILING ADDRESS: • Wit) a °�E ;' '<i1 e Va. f/ey ,e4),-, el CIC _- (CitY/state)1 ( IP) CON'IRACIOit: LICENSEI: - MAILING ADDRESS_ - •' . . PHONE t: • (street) (dty/state) (tea) DESCRIPTION OF WORK • • 3 OF(IMPS I COST EQUALS AMOUNT I FUEL BURNING G APPLIANCE .OR c 100.000 - •. X •• $15 • 2 FUEL BURNING APPLIANCE >102,000 X ' $192 3_ UNLISTED APPLIANCE(ADOrlIONAL PEE) -OR c 400,000 X $S0 6 UNLISTED APPLIANCE(ADDIIEONAL PEE) .e00,000 X 3100 5 USED APPLIANCE(WBEC min.AFUE Ming) ,or e600,000 X , $ • 6 USED APPLIANCE(WSEC ARAin.AFntln%) »00,000 X $100 - 7 BOR-ERIREFRICERATION 1-100M OTU X , $15 . I B EPRIGBRATlON 101•SOOM BT'tl X S2.3 . 9 BOILER/REFRICERATDON 501-1,100M OTU X$39 • 10 SOILER/RSFRIGCRAZION 1001.1,750Mwas ]( — 11 801tERIREFRICGRATTON +1730M BTU X 395 - • 12 CAS GOC,CAS INSERT.GAS FIREPLACE - X SYO - () 13 RANGE ORrER — X SWQ - • X $10 . u FUEL BURNING WATER HEALER - X $ Q 16 M= EL SURNING Am_ _ - X 510 . - n PAs P1PWG(a Oud.11 - ) • _ • 18 DUCTSY$TEM55 _X $10 . 19 VEN T LATINC FANS X $20 . 20 AIR KANDLBR(DOES NOT Induct.duetln -OR c 1 �� e oIRECFM X 512 21 AIRNDI.E$(DOES NOT Include ducfn RA >*OT CFM X $19 4.22 EVAPORATIVE COOL5) ERS - _ X $10 - -23 TYPE 11400D _ - X 550 - 26 TYPE BROOD _ X 510 2>2 HEAT FUIap/MR CONDITIONER 0-3 TON X $12 . - 26 AIR CONDITIONER 3-IS TON X S20 27 AIR CONDITIONER 15.30 TON X $25 28 AIR CONDITIONER 30-50 TON X SW . 29 AIR CONDmoNER - +50 TON X $60 " - 30 LPG STORAGE TANK - _ _ X $10 - - 31 WOOD OR PELLETSIOVE/IN5ERP - X • 310 - ` 32 WOOD STOVE.FREE STANDING T X $23 SUBTOTAL i ZY.00 METHOD OP PAYMENT PLUSPROCESSING FEE $35.00 iler to TOTAL PERMIT PEE DUE: 0 CASH 0 CHECK ❑ 0 { • DATE: EXPIRES: BANXCARD NUMBE1z - AUT!-3ORI2EDSIGNATURE.: - .- _ SO'SO'd P6089E6 01 ad 10:LS 200E 0Z d3S go . © OI Z ► r, t This site plan is being:miltedfor the purpose of obtaining a building I truewnproperty correct representation of the propoosi lines/dime • curb lines,structures and easements have b- n i• tified• MID ' •other critical areas. bodies •f wimiJ Signed:t/ 441111, Date. --- I t / 1 P , 9l-1 911 .. Lr UJ N • / AIP p `L� ,1( / ,q� ADDRES _ � �(� t 1 � "6 VC(iA (�i4 a r'fr.e VZONE .rte F p ROAD WID r ii L-04-r--0 4- 3 z 1 II Q FRONT3 F , I .c COMMENTS / 1111 REVIEWED : VAa!IN►"' r , '.if t'r' 2or