2003, 12-12 Permit App: BLD-03-03263 Residence 00"\ft, ,
SFolane
j "alley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone: 509 688-0036 Fax: 509 . ;: 1137
REQUIRED SITE INFORMATION
STREET ADDRESS: 1/ '1 4 f JA4 JJ `./ ~
' .
ASSESSOR'S TAX PARCEL) MBER(S):
LEGAL DISCRIPTION: /A A..t e.a. . .�_/iii 11 i
0c>1v."} !. ,--(`. -) J ,, Put)
PER DESCRIPTION:
UILDING PERMIT - CI CHANGE IN USE - 0 GRADL'4G .13 MANUFACit'KZD HOME
13 RELOCATION a SIGN Q TENANT BOTHER
OWNER /APPLICANT INFORMATION .N
0 OWNER: CI APPLICANT:
PHONE: FAX: PHONE: FAX:
.
ADDRESS: ADDRESS:
e , .
CITY,ST E,ZIP CITY,STATE,ZIP
13CONTRACTOi1 �1.JIAkJd LI 4 I ❑ ARCHITECT:
1.1
,�. s. II I
PHON /�. - Kt 11 PHONE: FAX:
ADDRESS: /1 4i�. .4,,./.�t ADDRESS:
„C ,.$TATE,ZIP CITY,STATE,ZIP
WA ST CONTRACTOR UCENSE I (ri, CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 30%SLOPES ON PROPERTY: ND MAIN FLOOR SQ FT:�
BUILDING HEIGHT TO PEAK:) U f-(011
OCCUPANCY GROUP:. 2ND FLOOR SQ FT:
BUILDING DIMENSIONS:6 f $WD CONSTRUCTION TYPE: UNFIN BASEMENT: 27L1
NUMBER OF STORIES: I STRUCTURES ON PROPERTY: 0 FINISHED BASEMENT: (OB
NUMBER of BEDROOMS: CRMCAL AREAS: GARAGE: 1179
FLANKING SETBACK: CURRENT PROPERTY SIZE: I// (pc-2 0 COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: V DECK: 120
REAR SETBACK: . 14-
CURRENT SEPTIC USE:
LEFT SETBACK: CURRENT WELL USE:
lf
-
RIGHT SETBACK: / IMPERVIOUS SURFACE AREA: �S 7
SVOrkan°°/\"'e •
• PLUMBING PERMIT APPLICATION
ADPORESECTS: / I 7
VJA 'JLA_ '
PERMIT
USE:
OWNER PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (zip)
CIOR: LICENSE#: je .7387 lc p
4 p •
gni
MAI ADDRESS: ONE#: .
&i; — 4e 7q
17L ,d. r1') `tai- ,
(street) (city/state) (zl')
PLUMSINC FIXTURES
DESCRIPTION DETAILS #OF ma X COST EQUALS • AMOUNT
1 TOILETS WATER CLOSET,BIDETS NS - X $6 i •
2 URINALS • X $6
3 TUBS X $6 i
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 i •
5 SINKS LAVS/BASINS,BAR,FLOOR. X $6
KITCHEN.LAUNDRY,UTILITY,
JANITOR,PHOTO,X-RAY,FOOD, i
PREP/CUUNARY/MEAT
6 DISHWASHER / X • $6 a
7 CLOTHES WASHER / X $6 a• ' GARBAGE DISPOSAL t X $6 s
9 WATER SOFTENER X $6
10 ELEC HOT WATER TANK NOTE:IF GAS SEE MECHANICAL X $6 =
11 FLOOR DRAINS AREA.CASE,COIL,TRENCH, $6
CONDENSATE / X =
12 FOUNTAINS,DRINKING , X $6 =
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION, X $6
WASTE,VENT, REPAIR,REVERSALS
. PLUMBING REVERSAL i
14 SEWAGE EJECTOR GRINDER,SUMP PUMP _ X $6 si
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, X $6
HOSE BIB,STEAMER,PROOFER, • _.
CARBONATOR,SWAMP COOLER 3
_
16 CROSS CONNECTION VACUUM BREAKER,CHECK • X $6
DEVICE VALVE,AND R.P.B.P.D.FOR:
VATS,SUMPS,TANKS,BOILERS i
17 SPRINKLER SYSTEM j X $25
18 INTERCEPTORS GREASE TRAP,SAND TRAP, • $6
CHEMICAL HOLDING TANK X .
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 i
20 MISC PLUMBING FIXTUREX $6
SUBTOTAL .
0 CASH 0 CHECK 0 willow 0 — ==`.' PLUS PROCESSING $35.00
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT FEE
OF A MAJOR CREDIT CARD
• TOTAL PERMIT FEE
DUE
DATE: ••
BANKCARD NUMBER: •
AUTHORIZED SIGNATURE: ,
•
po ae ,
d# Valley
/ VJA/jeL4
MECHANICAL PERMIT APPLICATION
ESS: �I IL „, PERMIT
USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) •(zip)
CO f: Q i
MAILING ADISR SS: IKr.
E EAA lvii, eit
. PHONE it: 1464 -- I 405--4° lq &-1' 0 / / i 4 / •
9907
(street) (city/state) (Zip)
DESCRIPTION OF WORK #OF UN/7Y X COST EQUALS AMOUNT
I FUEL BURNING APPLIANCE =OR<100.000 j X $15 =
2 FUEL BURNING APPLIANCE X100,000 X $19 -
3 UNUSTED APPUANCE(ADOMONAL FEE) =OR<400,000 X $50 =
4 UNUSTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 =
5 USED APPUANCE)NSEC min.AFUE rating) auR400,000 X $50 -
6 USED APPUANCE(WSEC min.AFUE rating) >400,000 X $100 =
7 BOILER/REFRIGERATION 1-100M BTU X $15 =
8 BOILER/REFRIGERATION 101.500M BTU X $28 =
9 BOILER/REFRIGERATION 501-1,000M BTU X S39 =
10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 =
11 BOLLER/REFRIGERATION +1750M BTU X $95 =
12 GAS LOG;GAS INSERT,GAS FIREPLACE - ., X $10 =
13 RANGE - / X $10
_
14 DRYER -
/ X $10 a
15 FUEL BURNING WATER HEATER - / X $10 =
16 MISCELLANEOUS FUEL BURNING APPL - X $10 =
17 GAS PIPING(ea.Outlet) - X $1 =
18 DUCT SYSTEMS - X $10 -
19 VENTILATING FANS - X $10
20 AIR HANDLER(DOES NOT include ducting) 0R<10,000CFM X $12 a
21 AIR HANDLER(DOES NOT Include ducting) >10,000CFM X $19 a
22 EVAPORATIVE COOLERS - X $10 =
23 TYPE I HOOD - X $50 =
24 TYPE II HOOD - / X $10 =
25 HEAT PUMP/AIR CONDITIONER 0-3 TON / . X $12 =
26 MR CONDITIONER 3-15 TON X $20 -
27 AIR CONDITIONER 1540 TON X $25 a
28 AIR CONDITIONER 30-50 TON X $35 =
29 AIR CONDITIONER +50TON X $60 =
30 LPG STORAGE TANK - • X $10 a
31 WOOD OR PELLET STOVE/INSERT - X • $10 =
32 WOOD STOVE-FREE STANDING - X $25 . =
IOW -*,.r SUBTOTAL
0 CASH 0 CHECK 0 111111011111 0 �- PLUS PROCESSING
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYITZENT $35.00
OF A MAJOR CREDIT CARD FEE
TOTAL PERMIT FEE
DATE: • EXPIRES: DUE
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
, .../ , ,. _
inc
l
/ PLANNING DEPT. APP OV - I
BY
4
idfliAvt•
f--, u
c-/ , fear Setbet4-- DATE: 17— i, 04,
v , /
03 /
,.„, ..„.„, ,
:::? :8 d ,
Loi
r• /
(1)/
/
/ .---\/
/ I
/ 60' ssL-'7
/ i o
.0
/ /
(o
ho 2 ,
/ use
, c,
,
r rVUON.- S4, /
/
/1:) /
• /
/
.•
•
/
.. ,
...
• — _____ ,,4 s sewer
-we /
• : -.... .•
,•
-,,-
,
i / / 1/43.
•
.
•
,
. ,.
, .
• . i ——, - 7•--- -,. ,,_ 0
• .
• •
. ---__
• ,,/gps , / -:.-\.„
-------_-:-------_---------- __ •• .3.----„,,, . --.
•-... c9
, , .. 0
/r-,-,)(,/ / - ,
N
---....„.„.,, N
-----..:_..l......1/\11.__.,eg if %.111141141i:::„,,,,, . -..,,,.....„... ,. N
dollior""iiiiiii 4 • -- ,
111 1111
io :C4ct.eik-_ PINE ROCK RIDGE 1ST ADDITION
gillii11111...doillli LOT 2 BLOCK 1
O 10 20 40 Founded 1946
0:111 .
111011111.11....iii trapson EnTneers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
SEPTEMBER 2003 PHONE (509) 926-1322 FAX (509) 926-1323
_
Lexington Homes 3714 S.Vercler