2004, 01-24 Permit App: BLD-04-03476 Residence •
City of 619g-Doi(p
SPOKANE VALLEY X ( - 0037
PERMIT # 1) -c i - C
BUILDING PERMIT APPLICATION
Box.1 OWNER \ �
� C�„ . JOB LOCATION \),.Z,\ � �,�,�•P���.
OWNER'S ADDRESS CITY PHONE
•
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED t
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME \ '-�"----'-----
C�� � C� ,..�� PHONE
;ONTRACTOR'S ADDRESSS � �� CITY
CONTRACTOR'S REG.#\��C�� =y� � EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
•
BOX 3 CONTACT PERSON OF PROJECTPHONE
CSC, ` ---`--�---
ADDRESS CITY
--- ZIP
BCX 4 ~EWER AVAILABILITY C WATER -
� AVAILABILITY
�
BOX 5 cSTIMATED PROJECT COST$ \\1,��rJ
EXISTING BLDG.VALUATION$
BOX 6 PROPERTY TAX ACCOUNT NUMBER —
LEGAL DESCRIPTION
c « f
NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• r-NSUS NUMBERr
LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR / 2ND FLOOR • /
•
3RD FLOOR / OTHER ' / BASEMENT FINISHED
f "
I ASEMENT UNFINISHED - / - DECK - / - GARAGE Nom\ /
-__ ,1RPORT / TOTAL___/ HEIGHT TO PEAK OF BUILDING FT.
30X 8 -�---------
) SINGLE FAMILY ( J) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) . ( ) EXISTING STRUCTURE
( ). COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY \O\\4 SQ. FT.
( ) TENANT IMPROVEMENTI •
• IMPERVIOUS SURFACE_ �...-���I SQ. FT •
3OX 9 PLUMBING FIXTURES (Including rough-ins) --'
MECHANICAL APPLIANCES
,_EASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
'STEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSItN BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL
•I
OX 10 Water Service meter size (if known) '-�
Also see BOX 4
OX 11 Septic Tank-Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
OX 12 Street use may require a " Street Use Permit"for sewer, water, sidewalks, curb cuts.Contact the Public
Works Department.
IERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
•
DRRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
30VE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
NNER/AGENT _ DATE \- ��
�' (OVER)
•
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard ---- Expiration Date
P.int the name of the Holder
Signature
• • OFFICE USE ONLY-PLEASE DO NOT WRITE BELOW THIS LINE
ZONE SETBACKS: FRONT SIDE REAR
HEIGHT LIMIT
PLANNING DEPARTMENT APPROVAL DISAPPROVAL
DATE
RL .LARKS
i
SEPA: EXEMPT •• NOT EXEMPT
FIR` DEPARTMEN1kPPROVAL DISAPPROVAL DATE
RE',ARKS
•
-4 .
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL
DATE
TYF'. OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT
• NE: COMMERCIAL COMM.ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION STORIES .
BUILDING SQ. FT. @ _
--- BUILDING SQ. FT. @ _
. BUILDING SQ. FT. @ _
BUILDING SQ. FT. • @
TOTAL SQ. FT. TOTAL VALUATION.
'BUILD ING PERMIT NO. PLAN.CHECK FEE REC'D RECEIPT NUMBER
PER IT FEE •PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOT, L FEES WSBCC SURCHARGE • ENERGY SURCHARGE
•
OTHER CHARGES ;I • AMOUNT DUE
BUILDING DEPARTMONT APPROVAL . .BY
DATE •
•
ASSIGNED ADDRESS •
•
•
1 •
nI` ry n �` 11707 East Sprague,A�:enue,Suite 106
Spokane Valley,WA 99206 509-688-0036-Phone
p
....,, Valley For Inspections, call 509-688-0054509-688-0037-Fax
Plumbing Permit Application
PROJECT
PERMIT
ADDRESS: \')...)....,s, RR\ USE:
OWNER: \\
(� �Q y,�`c� 'PHONE(Daytime Contact):
MAILING ADDRESS: C..._ ,--
(street) (city/state) (ZIP)
CONTRACTOR:
LICENSE it:
MAILING ADDRESS:
PHONE it:
(street) (city/state)
(ZIP)
PLUMBING FIXTURES
DESCRIPTION DETAILS t OF UNITS X
1 TOILETS COST EQUALS AMOUNT
WATER CLOSET,BIDETS � X
2 URINALS S6
3 TUBS X $6
4 SHOWERS(PER TRAP) BATH,STALL„ON-SITE BUILT 1 X $6
5 SINKS ` X
LAVSBASINS,BAH FLOOR,KrrCHEN,
LAUNDRY,UTILITY,JANITOR,PHOTO,X-
RAY,FOOD,PREP/CULINARY/MEAT X u'
6 DISHWASHER
7 CLOTHES WASHER , X $6 -
8 GARBAGE DISPOSAL ` X $6 •
9 WATER SOF I LINERX $6 -
F 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL X $6 •
X
11 FLOOR DRAINS AREA,CASE,COIL TRENCH,CONDENSATE X $6
12 FOUNTAINS,DRINKING
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, X
WASTE,VENT,PLUMBING REVERSALS
REVERSAL X $6
14 SEWAGE EJECTOR GRINDER,SUMP PUMP
15 WATER USING DEVICE X 56 -
ICE AND/OR COFFEE MAKER,HOSE BIB,
STEAMER,PROOFER,CARSONATOR, ZS X
SWAMP COOLER
6 CROSS CONNECTION DEVICE VACUUM BREAKER CHECK VALVE,AND
R.P.B.P.D.FOR:VATS,TANKS,BOILERS X $6
it 17 SPRINKLER SYSTEM
18 INTERCEPTORS X 325
GREASE TRAP,SAND TRAP,CHEMICAL
HOLDING TANK X $6 •
19 MEDICAL GAS per outlet NITROUS,OXYGEN
:0 MISC.PLUMBING FIXTURE
X $X $6
6
LET:IO D 01 ',YMENT SUBTOTAL:
. t-----,,...-
] CASJ-: CHECK ❑ ❑ i --<::h_'.j PLUS PRCkESSING FEE: $35,00
•
TOTAL PERMIT FEE DUE:
ATE: EXPIRES:
.NKCARD NUMBER:
JTHORIZEr ' GNATURE:
•
n101-1.t 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
. pokane Spokane Valley,WA 99206 509-688-0037-Fax
,Valley For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT PERMIT
ADDRESS: \�-)2\ �� •1,R 4... USE:
OWNER PHONE(Daytime Contact):
MAILING ADDRESS.
(street) (city/state) (ZIP)
CONTRACTOR: LICENSE S:
MAILING ADDRESS: PHONE 8:
(street) (city/state) (ZIP)
DESCRIPTION OF WORK t OF UNITS X COST EQUALS AMOUNT
I FUEL BURNING APPLIANCE -OR<100,000 \ X $15 -
2 FUEL BURNING APPLIANCE >100,000 X $19 -
3 UNLLcTED APPLIANCE(ADDITIONAL FEE) -OR<400,000 X $50 -
4 UNLISTED APPLIANCE(ADDMONAL FEE) >400,000 X $100 -
5 USED APPLIANCE(WSEC min.AFUE rating) -or<400,000 X $50 -
6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 -
7 BOILERIREFRIGERATION 1-100MBTU X $15 -
8 BOILER!REFRIGERATION 101-500MBTU X $28 -
9 BOILER/REFRIGERATION 501-1,000M BTU X $39 -
10 BOILER/REFRIGERATION 1001-1,750M BTU X . $57 -
11 BOILER/REFRIGERATION +1750M BTU X 595 -
12 GAS LOG,GAS INSERT,GAS FIREPLACE - .k X $10 -
13 RANGE - X $10 -
14 DRYER - X $10 -
15 FUEL BURNING WATER HEATER - \ X $10 -
16 MISC.FUEL BURNING APPL. - X $10 -
17 GAS PIPING(ea.Outlet) - x n -
18 DUCT SYSTEMS - X 310 -
19 VENTILATING FANS - •• X $10 -
20 AIR HANDLER(DOES NOT include ducting) -OR<10,000CFM X $12 -
21 AIR HANDLER(DOES NOT indude ducting) >10,000 CFM X $19 -
•
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 AIR CONDITIONER 3-15 TON ' X $20 -
27 AIR CONDITIONER 15.30 TON X $25 - •
28 AIR CONDITIONER 30.50 TON X $35 -
29 AIR CONDITIONER +50 TON X 360 -
30 LPG STORAGE TANK - X $10 -
31 WOOD OR PELLET STOVE/INSERT — X $10 -
32 WOOD STOVE•FREE STANDING — X $25 -
SUBTOTAL
METHOD OF PAYMENTPLUS PROCESSING FEE $35.00
I.. TOTAL PERMIT FEE DUE:
Y/SA' fiea I;^r1 rc'
E C'.N ❑ CHECK ❑ Minn 0 I__:._.:2'.
•>A1-1 EXPIRES:
:3ANI .RD NUMBER:
S 89'58'00" W
16.0 . ^ 95.50' / n
L STA 4+90.00 ,'/ 1 Ti .,. ,. SWALE /
1 = 2056.73
���i 4 c I •'BOTT EL = 2056.00
STA 4+62.00 ,I�� ••BOTTOM AREA 240 . FT.��
1 = 2056.94 '"'
'TYPE B DRYWELL
25.0' — —I— —I 'W/TYPE 4 METAL
I 1FRAME AND GRATE
RIMEL = 2056.00
0 I STA 2+95, RT 30' _
IW A
O Q V
CC o i6 Q 1•
� 1 I
11, o IQ .Z o
a_ O _J C.
flb
.S' 0f
• S 89'58'00" W I
95,34'
PLANNING DEPT. APPROVED 6 v'% •
BY '. 11/&/ 4ev ..._____ OF UP--3-5—2 N
0 ,•v6 s-re
-tc-t-
62 .6 '
DATE: d2• b T 645' I 3
fl
2' 16' 2' 3'0.75'
7,/,„,,,,, ,,,,);;,?.,4";;,/,‘" iii,i '•i;-, ' 10.50'
I-2- , .........
4-!)\-1
a ti?,I
SWALE SECTION L Allfr%
S NTS .s
0 1Imill..... .1530 60 `�--1\ S. \N ,\c•, \Lfi/ �'. 7 �� Ln
co
"%NAL � . 0�'�
VALLEY PINES SUBDIVISION Jrn
1 inch = 30 ft. LOT 1 — BLOCK 1 EXPIRES 12 1 00
O
Z
HAHN ENGINEERING N. 8623 SUITE B DIVISION SPOKANE, WA. 99208 0
a