2004, 09-27 Permit App: BLD-04-07767 Residence BUILDING PERMIT APPLICATION WORKSHEET
SC1TFtl€ City of Spokane Valley Community Development Department
ne Building Division
Vlle . Sprague Avenue, Suite 106
.0,00aev Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: '3 '7 o E. s) uelec=.�.�
Assessor's Tax Parcel Number(s): '/S S/'Z . Z /Ott
Legal Description: Lb r kt 64_ K. a_
PERMIT DESCRIPTION: j iG'L CP
[23uilding Permit El Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: ❑ Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City Sta a Zip Code City State Zip Code
Contractor: C l S .n,fiZ evn,9r El Architect:
Phone: '94q-7 3-R Fax: ri- 91/-2/ Phone: Fax:
Address: /&5Ze> E 5fc&1rt4 r- Address:
ClAze w } 4403 7
City State Zip Code City State Zip Code
WA State Contractor License #: e-• IGLSSG/of'e<Contact: (.i PF
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:Z3) DIMENSIONS: #OF STORIES:
��k �- Z.-
MAIN FLOOR TO,Qj"G: 2"" FLOOR SQ. FTG: UNFIN B%�i t NT SQ. FTG:
FINISHED BASEMENT SQ. FTC: GARAGE SQ. FTG: DECK/CIV. PATIO SQ, G:
ler /O 3S" C�`•.. ' `T /
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SO �-CE:
6', -S
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
2-/ Z-I-?
COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM? SQfk.)€-r-
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 Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT LI WELDING
Firm Name: Phone: Fax:
I nspector(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 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 ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
Wiley 11707 E. Sprague Avenue, Suite 106
doeSpokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509)688-0037
FOR INSPECTIONS, CALL(509)688-0054
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: \I l M VYI L(S License#: Phone#:
Mailing Address:
City State Zip Code
*OF TOTAL
DESCRIPTION OF WORK UNITS q X COST - AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS 7 X $6.00 =
3 TUBS 7 X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT Z X $6.00 =
5 SINKS LAVSIBASINS,BAR,FLOOR,
KITCHEN,LAUNDRY,UTILITY, 6.)
X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CULINARY/MEAT
6 DISHWASHER ( X $6.00 =
7 CLOTHES WASHER X $6.00 =
8 GARBAGE DISPOSAL I X $6.00 =
9 WATER SOFTENER X $6.00 =-
10
10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL X $6.00 =
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, 1 X $6.00
CONDENSATE
12 ROOF DRAINS/OVERFLOWDRAINS X $6.00 =
13 . FOUNTAINS,DRINKING X $6.00 =
14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 =
VENT, PLUMBING,REVERSAL REPAIR,REVERSALS
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
16 WATER USING DEVICE ICE AN/OR COFFEE MAKER,
HOSE BIB,STEAMER,PROOFER, 3 X $6.00 =
CARBONATOR,SWAMP COOLER
17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK
VALVE,AND R.P.B.P.D.FOR: X $6.00 =
VATS,TANKS,BOILERS
18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 =
CHEMICAL HOLDING TANK
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
METHOD OF PAYMENT: SUBTOTAL
❑ CASH ❑ CHECK Q VISA Q MASTERCARD PROCESSING FEE $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
0.°1"\*4MECHANICAL PERMIT APPLICATION
S'pokane City of Spokane Valley Community Development Department
BuildingDivision
galley 11707 E. Sprague Avenue, Suite 106
di 000
Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509) 688-0037
FOR INSPECTIONS, CALL(509) 688-0054
Project Address: 3 120-e- Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: A Litt f i4ivl°ik€s i License#: Phone#:
Mailing Address:
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 l X $15.00 =
2 FUEL BURNING APPLIANCE More than 100,000 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 =
USED APPLIANCE(WSEC min.AFUE
5 rating) Equal to or less than 400,000 X $50.00 =
USED APPLIANCE(WSEC min.AFUE
6 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 I X $10.00 =
13 RANGE X $10.00
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER I X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 3 X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS II X $10.00 =
20 AIR HANDLER(DOES NOT indude 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 II HOOD I X $10.00 = ,
25 HEAT PUMP/AIR CONDITIONER 0-3 TON I 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 =
METHOD OF PAYMENT: SUBTOTAL
0 CASH CICHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
2001 WSEC.Residential Compliance Form
Prescriptive(Chapter 6) Options for all R Occupancies,Climate Zone 2 0; 1
Guy of Heat source: ALL -
SPOKANE VALLEY BUILDING DEPARTMENT - •
• 11707 E.Spraage Avenue,11106,Spokane Valley,Washington 99206-Tel 509-921-1000-Fax 509-921-1008
SITE ADDRESS: 37a2 s, ()add.PERMIT NO. DATE: q'z l-Oy
INSTRUCTIONS
I) Your permit will be processed more efficiently if you provide all of the requested information. Department staff can
help you with general questions about this form. Your building must match the selected option requirements without
exceptions or substitutions.
2) Glazing percentage determines which option to choose. Complete the following glazing area calculation before
proceeding to the option table below.
GLAZING AREA CALCULATION: /
3 94/ SF. — 24 n Z Z / SF- = 9, 3
TOTAL WINDOW AREA _ HEATED FLOOR AREA (ALL FLOORS) = %OF GLAZING
NOTE: Use rough opening(R/O)for window area. Include all half-lite and full-lite door glazing in this
calculation. -
CAN'T COMPLY? If none of the Prescriptive(Chapter 6)Options below are acceptable,consider systems analysis
(Chapter 4)or,Component Performance(Chapter 5) Approach.The main advantage is flexibility to juggle individual U-
factors(R-values)as long as an overall maximum value isn't exceeded. Note that the overall performance requirements _
are no less stringent than the Prescriptive requirements. Calculations may be performed by hand or, using an acceptable -
computer software program. Helpful forms and other resources can be downloaded at http://www_eriergy.wsu.edu/
buildings. -
/ • / 5k1 11G�ki-S
• Glazing U-Factoy' ' Wall'
Glazbg JJJ Wall Wall'int . Slab'on
Q Op- Area .%of Ceiling Vainted ext
Floor Vertical Overhead" U-factor Ceiling' Grade e Glad Below Floor' Grade
Grade -
cn I. 10% 0.40 0.58 0.20 R-38 R-30 n� R-21 R-12 R-30 R-10
a4 0 11.' 15% 0.40 0.58 0.20 R 38 R-30 Rte+ R-21 . R-12 R-30 R-10
O AR-19 '
0 18. 17% 0.37 0.58 0.20 R-38 R-30 R 5"+. R-21 R-12 R-30 R-10
O Un n ted
VI a 0 IV. Gry 035 0.58 0.20 R-38 R 30 int tz R-21 R-12 R-30 R-10
W Q _ .
O
OE" - 0- Nominal R-values are for wood frame assemblies only or assemblies built in accordance with Section 601.1
W1. Mninrm requirements for each option listed For example.if a proposed design has a glazing ratio to the conditioned floor area of 13%,it
T � M shall oarply with all of the requirements of the 15%glazing option(or higher). Proposed designs,which cannot meet the specific
L./ U requirements of a listed option above,may calculate compliance by Chapters 4 or 5 of this Code.
Q • 2. Requirement applies to all oeiings except single rafter or joist-vaulted ceilings. 'Adv'denotes Advanced Framed Ceiling.
WL3. Requirerrhent applicable only b single rafter or joist vaulted cams.
CI < 4. Below grade wets shalt be insulated either on the exterior to a minimum level of R-12.or on the interior to the same level as walls above
grade. Exterior insulation installed on below grade walls shall be a water resistant materiat,manufactured for its intended use,and installed
according to the rtanufacicrer's specifications. See Section 602.2
V) rl
H 5. Floors over crawl spaces or exposed to ambient air omdtions.
F-( n 6. Required slab perimeter insulations shall be a water resistant material:manufactured for its intended use.and installed according to
manufacturers specifications.
7. Int denotes standard training 16 inches on center with headers insulated with a minimum or R-5 insulation.
8. This wall insulation requirement denotes R-19 wall cavity insulation plus R-5 foam sheathag.
9. Doors.including all fire doors,shall be assigned default U-factors from Table 10-6C.
10. Where a maximum glazing area is listed,the total glazing area(combined vertical plus overhead)as a percent of gross conditioned floor area
shall be less than or equal to that value. Overfeed glazing with U-factor of 1.-4.40 or less is not included in glazing area Irritations.
11. Overhead glazing shall have U-factors detemined in.aocordance with NFRC 100 or as specified in Section 502.1.5.
12. Log and solid tinier walls with a minimum average thickness or 3.5-are exempt form this insulation requiremen t
- Form 5-050801-2001 Residential Comp Form
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11111ImmIl"'l limpson Engineers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
SEPTEMBER 2003 PHONE (509) 926-1322 _ FAX (509) 926-1323