2005, 09-01 Permit App: 05003132 Residence Project Number: 05003132 Inv: 1 Application , Date: 09/01/2005 Page 1 of 3
THIS IS NOT APERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE-GAS Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E.SECRETARIAT
C-S-Z: VERADALE,WA 99037
Setbacks: Front 25 Left: 16 Right: 30 Rear: 30 Phone: (509)922-4297
Group Name:
Site Information: Project Name:
Plat Key: Name: SHELLEY LAKE 4TH ADD PUD District: East
Parcel Number: 45244.3107 Block: 3 Lot: 7
SiteAddress: 16512 E 9TH LN Owner:Name: SCHMITZ,CLIFFORD&MARGO
Address: 16520 E SECRETARIAT LN
Location::CSV SPOKANE VALLEY,WA 99037-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 11,129 Sq Ft Width: 83 Depth: 113 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Released By:
Originally Released: 09/01/2005 By: cjjanssen
Plan Review Released By:
Originally Released: 09/01/2005 By: TMELBOU
Approach/Drainage Released By:
Originally Released: 09/01/2005 By: cjjanssen
Sewer Review Released By:
Permits:
Operator: CJJ Printed By: CJJ Print Date: 09/01/2005
Project Number: 05003132 Inv: 1 Application Date: 09/01/2005 Page 2 of 3
THIS IS NOT A,PERMIT
Penalties will be assessed for commencing work without a permit
Approach
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
Item Description Units Unit Desc Fee Amount
APPROACH INSPECTION 1 NUMBER OF $25.00
CONST IN ROW-APPROACH 1 NUMBER OF $25.00
Permit Total Fees: $50.00
Building Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VB 1,555 $23,325.00 1,555 $23,325.00
DECK R-3 VB 45 $675.00 45 $675.00
GARAGE U-1 VB 440 $8,360.00 440 $8,360.00
RESIDENCE R-3 VB 1,567 $117,023.56 1,567 $117,023.56
Totals: 3,607 $149,383.56 3,607 $149,383.56
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,273.75
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $509.50
Permit Total Fees: $1,787.75
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509)325-4505
SPOKANE,WA 99202
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 3 NUMBER OF $30.00
CLOTHES DRYER 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $85.00
Operator: CJJ Printed By: CJJ Print Date: 09/01/2005
Project Number: 05003132 Inv: 1 Application . Date: 09/01/2005 Page 3 of 3
THIS IS NOT A,PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: JIMMY'S PLUMBING Firm: JIMMY'S PLUMBING
Address: 1702 S MAMER Phone: (509)928-8991
SPOKANE,WA 99216
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 2 NUMBER OF $12.00
SINKS 4 NUMBER OF $24.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Permit Total Fees: $96.00
Notes:
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,787.75 $1,787.75 $0.00 $1,787.75
Mechanical Permit $85.00 $85.00 $0.00 $85.00
Plumbing Permit $96.00 $96.00 $0.00 $96.00
$2,018.75 $2,018.75 $0.00 $2,018.75
Disclaimer:
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: CJJ Printed By: CJJ Print Date: 09/01/2005
BUILDING PERMIT APPLICATION WORKSHEET
cm'(f 1111.1A41110k City of Spokane Valley Community Development Department
Building Division
D p �� rJI 11707 E. Sprague Avenue, Suite 106
Valley Spokane Valley, WA 99206
40, ��ne: (509) 688-0036;Fax: (509) 688-0037
1112 ..... _
L: 3illi E III . •RMATION
Street Address: ( Si Z-
Assessor's Tax Parcel Number(s):
Legal Description:
t AU( 3 .seilei (4. ti-P- 461_,d
PERM) DESCRIPTION: 2.es /19-on c e
Building Permit 0 Change in Use ❑ Grading 0 Manufactured Home
0 Relocation 0 Tenant Improvement 0 Fire SRfety 0 Other
I
OWNER/APPLICANT INFORMATION I
❑ Owner: ir‘i\tN0 Applicant:
hone: / Phone: Fax:
Address: Address:
City state zip Code City State Zip Code
EV. Contractor: (I)cF- S c-t+ u 1Z- 'S r- 0 Architect:
Phone:qqq..77 3 3 Fax: 1.41-/-71 Phone: Fax:
Address: 16czo E• c(2/...A;K.r Address:
1A),C la-OVY/g_ (Jif Rgo39 City State Zip Code State Zip Code
WA State Contractor License#: 61-42/aye Contact: 4
if-P
I g PERMIT/BUILDING INFORMATION 1
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FT ....6),, cr./J 2'a"FLOOR SQ. FIG: UNFIN BASEMENT, SQ. FTG:
I 1►L! 1 �- DECK/COV. PATIO SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
3 31Cv
COST OF PROJECT: 30%SLOPES PROPERTY: SEW ERM?OR ON- ee
SEPTIC
y
[ INSPECTORS COPY litroi 1 1
MUST BE ATTACHED TO APPROVED PLANS
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ra.iuslwo.nv ...••••••• ••• , �••••••........ -' Building Division
sour, 11707 E. Sprague Avenue, Suite 106
Phone: (509)688-0036;FAX: (509)688-0037
diValleY
For Inspections,Call(509)688-0054 Spokane Valley, WA 99206
Project Address: • Permit Use:
Owner. Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: T I rn 0\4 S 04.1,0r 131 rV 6 License#: Phone*:
Mailing Address: City State Zip Code
DESCRIPTION OF WORK
OF UNITS X COST is TOTAL AMOUNT
1 TOLETS WATER CLOSET,BIDETS Z.- X $6.00 =
X $6.00 =
2 URINALS
X $8.00 =
3 TUBS
4 SHOWERS(PER TRAP) BATH.STMT...ONSITE BUILT I X $6.00
• LAVSIBASINS.BAR.FLOOR.KITCHEN. zi
X $B 00 =
5 SINKS UWW)RY.UTILITY.JANITOR.PHOTO.
X-RAY,FOOD,PROMUUNARY MEAT 1
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 ELECTRIC HOT WATER TANK NOTE: IF GAS.SEE MECHANICAL X $6.00 =
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH.CONDENSATE 1 X $6.00 =
ROOF DRAINS/OVERFLOW X $6.00 =
12 DRAINS
13 FOUNTAINS.DRINKING X $6.00 . _
WATER PIPING/DRAM-IN WASTE. NSTALLATION,ALTERATION,REPAIR, X $6.00 =
14 VENT,PLUMBING,REVERSAL. REVERSALS
i 15 SEWAGE EJECTOR
GRINDER.SUIT'PUMP X $6.00 = ?
ICE ANIOR COFFEE MAKER.HOSE 818. X $6.00 =
16 WATER USING DEVICE STEAMER 3
PROOFER.CARBONATOR.SWAMP COOLER
VACUUM BREAKER.CHECK VALVE, X $6.00 =
17 CROSS CONNECTION DEVICE _ AND ILP.BP O. .TGREASE S.TANKS,D TRABOILERS
18 INTERCEPTORS CHEMICAL HOLDING TANK X $8.00 =
19 MEDICAL GAS(per oulkf) NITROUS.OXYGEN X $6.00 =
MISCELLANEOUS PLUMBING X $8.00 =
20 FIXTURE .
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00
INDUSTRIAL WASTE X $15.00 =
22 INTERCEPTOR • SUBTOTAL
METHOD OF PAYMENT: PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
$35.00
DATE: : TOTAL PERMTT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION Community Development Department
,� ii, Building Division
Phone:(509)688-0036;FAX:(509)688-0037 11707 E.Sprague Avenue, Suite 106
/I* For Inspections,Call(509)6'88-0054 Spokane Valley,WA 99206
Project Address: Permit Use:
Owner: Phone(Daytime Contact):
Mailing Address: Gtr spew z4 Coe
Contractor: S'VU L( Wk CC l\-( 6 License#: Phone#:
Mailing Address: City sew z4 Coss
DESCRIPTION OF WORK C OF UNITS X COST a TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less Nen 100,000 _ f X $12.00
_ 2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 =
3 UNLISTED APPLIANCE(AdrFiornl Fee) Egg to or less Iran 400.000 X $50.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 , X $100.00 =
5 USED APPLIANCE(WSEC min.ARE nano) Egwl tD or less than 400.000 X $50.00 =
6 USED APPLIANCE( EC Rain AFiN:rating) More than 400,000 X $100.00 =
7 BOILER/REFRIGERATION 1-100M BTU X $12.00 =
8_ " TION 101-500M.1TU X $20.00 =
9` BOILERUREFRIGERATON 501-1.000M BTU X $25.00 =
10 BOILERIREFRIGE .-
1,001-1,750M BTU X $35.00 =
•
11 BOILER/REFRIGERATION More than 1.75016 BTU • X $60.00 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE I X H $10.00 =
13 RANGE X $10.00 =
14 DRYER
X $10.00 =
i =
15 FUEL BURNING WATER HEATER x $10.00
16 MISC.FUEL BURNING APPLIANCE x $10.00 =
17 GAS PIPING(each outlet) 3x $1.00 =
18 DUCT SYSTEMS x $10.00 =
19 VENTILATING FANS3 X $10.00 a
20 AIN HANDLER(DOES NOT include duesay) Equal to or less than 10,00D CFM X $12.00 =
21 AIR HANDLER(DOES NOT include duct aa) Gtes1er than 10.000 CFM X $15.00 =
22 EVAPORATIVE COOLERS X , $10.00 =
X $5000 =
23 TYPE i$1000 _ 5
I )( ;10.00 =
24 TYPE I HOOD
25 HEAT.PUMPMIt CONDITIONER 0-3 TON X $12.00 =
3-15 TON X $20.00 =
2s Ala( T10N� 1530 TON X $25.00 = �
27 AIR CONDIONER
28 AIR CONDITIONER 30-50 TON X $35.00 =
29 AIR CONDITIONER -More than 50 TON X $60.00 =
X $10.00 =
30 LPG STORAGE TANK
X $10.00 =
31 WOOD OR PELLET STOVEMISERT =
32 WOOD STOVE-FREE STANDING X X $25.00$ 5.00
33 REPAIR&ADDITIONS • X $12.00 =
34 VENTILATION SYSTEMS .00 =
35 VENTIJITION MECHANICAL • X $12EXHAUST X $12.00 s
so
38 INCINERATOR-REBID X M00 s
37 INCINERATOR-COMMERCIAL
SUBTOTAL
METHOD OF PAYMENT: $35.00
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE ,
EXPIRES: TOTAL PERMIT FEE DUE:
CARD V.
AUTHORIZED SIGNATURE:
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