2004, 06-25 Permit App: BLD-04-04797 Residence City of (0 -003(0
SPOKANE VALLEY Era)( (D� c'0037
PERMIT # 13LO a -
BUILDING PERMIT APPLICATION
Box.1 OWNER [ JOB LOCATION
OWNER'S ADDRESS CITY_ PHONE
DESCRIBE JOB �c T
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED f
PARTNERSHIP RRIED
19°7
CORP. 1. •
BOX 2 CONTRACTOR'S NAME ---
� PHONE_`�,�Z�ys
CONTRACTOR'S ADDRESSy \Z o\
CITY
CONTRACTOR'S REG.#\c\- � •
EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VE IFIED)
BOX 3 CONTACT PERSON OF PROJECT ,
r^ PH NE
ADDRESS I- i, (.
CII �
BOX 4 SEWER AVAILABILITY �� — —
TER'�"VAIIZAIL fir c•
BOX 5 ESTIMATED PROJECT COST$ toy mit•G
BOX 6 PROPERTY TAX ACCOUNT NUMBER •
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• CENSUS NUMBER r
LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR /\1`P 2ND FLQOR /
3RD FLOOR / OTHER ' / BASEMENT FINISHED
f
BASEMENT UNFINISHED /lit DECK / GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING \' FT,
•
30X 8
(1) SINGLE FAMILY ( f NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY_taiL
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE 2 , SQ. FT. •
— SQ. FT. •
30X 9 PLUMBING FIXTURES (Including rough-ins) ----�
• MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL
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)
DX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
/ERIFY 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 OV
( ER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
Visa Mastercard --- Expiration Date
Print 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
REMARKS
SEPA: EXEMPT - NOT EXEMPT
FIRE DEPARTMENTi)PPROVAL DISAPPROVAL DATE
REMARKS
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE
--------------------=------ ---------------•
------r
TYPE OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT
NEW 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 .
•BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER
PERMIT FEE .PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES ,' WSBCC SURCHARGE • ENERGY SURCHARGE
OTHER CHARGES !I AMOUNT DUE
BUILDING DEPARTMINT APPROVAL . BY
DATE •
ASSIGNED ADDRESS
•
S`
pcjOr‘ 11707 East Sprague Avenue, Suite 106 509-688-0036-Phone
Spokane Valley,WA 99206 509-688-0037-Fax
40000 valley For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT PERMIT
ADDRESS:\��.,� S .\�� \� USE:
OWNER PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state)
CONTRACTOR: LICENSE#:
MAILING ADDRESS: PHONE I:
(street) (city/state)
DESCRIPTION OF WORK I OF UNITS X COST EQUALS AMOUNT
I FUEL BURNING APPLIANCE •OR<100,000 \ X $15
2 FUEL BURNING APPLIANCE >100,000 X $19
3 UNLLSTED APPLIANCE(ADDMONAL FEE) •OR<400,000 X $50
•
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100
5 USED APPLIANCE(WSEC min.AFUE rating) •or<400,000 X 550 -
•
6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100
7 BOILER/REFRIGERATION 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 $95
12 GAS LOC,GAS INSERT,GAS FIREPLACE — .‘ 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 510
19 VENTILATING FANS — �1 T 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 1 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 $60 .
30 LPG STORAGE TANK — X $10 .
31 WOOD OR PELLET STOVE/INSERT — X $10
32 WOOD STOVE-FREE STANDING — X $25
•
SUBTOTAL:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00
11111111111111
VISA" n st yrG n+j TOTAL PERMIT FEE DUE:
1:1 ,co-I ❑ CHECK ❑ 0 — ..._.''` .-i
')ATT' EXPIRES:
IAN; 1RD NUMBER:
Y(1 t�� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
S�pokane Spokane Valley,WA 99206 509-688-0037-Fax
..Valley For Inspections, call 509-688-0054
Plumbing Permit Application
PROJECT PERMIT
ADDRESS:\�s; '\tea`` .\ USE:
OWNER: a PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR: LICENSE t:
MAILING ADDRESS: PHONE#:
(street) (city/state) (ZIP) '
PLUMBING FIXTURES
DESCRIPTION DETAILS it OF UNITS X COST EQUALS AMOUNT
1 TOILETS WATER CLOSET,BIDETS ,. X $6 -
2 URINALS X $6 -
3 TUBS 'L X $6 -
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT > X $6 -
5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, '
LAUNDRY,UTILITY,JANITOR,PHOTO,X- S X 'S6 -
j RAY,FOOD,PREP/CULINARY/MEAT
6 DISHWASHER \ X $6 -
7 CLOTHES WASHER \ X $6 - .
8 GARBAGE DISPOSAL X $6 -
9 WATER SOFTENER X $6 -
10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL . X $6 -
1I FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE .\ X $6 -
12 FOUNTAINS,DRINKING X $6 -
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR,
WASTE,VENT,PLUMBING REVERSALS X $6 -
REVERSAL
14 SEWAGE EJECTOR GRINDER SUMP PUMP X $6 -
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB,
STEAMER,PROOFER,CARBONATOR X $6 -
SWAMP COOLER
16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND X
R.P.B.P.D.FOR:VATS,TANKS,BOILERS
7 SPRINKLER SYS I EM X $25 -
8 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL
•HOLDING TANK X -
.9 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 -
20 MISC.PLUMBING FIXTURE X $6 -
SUBTOTAL:
IETHOD OF PAYMENT
• yam.,' I.!u'zskrii PLUS PROCESSING FEE: $35.00
] CASH ) CHECK ❑ ENESZES ❑ �_ _"*"..1
•
TOTAL PERMIT FEE DUE:
ATE: EXPIRES:
.NNKCARD 2' .ABER:
UTHORIZED S;GNATURE:
This silo plan Is being Iiib aiMad for the purpose of •
obtaining a building porn*mad is a true and correct
representation of the proposal. Alt known property D
tines/dimensions.curb linos.structures and easements ADDRESS i C( ;l 1 t lam/ I `�F
have been IdenSNed• Meg imitated are wetlands, ZONE i,(bathes d . steep slopes or other critical areas. Vf�g �
1 j"�G�-l/P Gt d lCrYLQ ROAD fRONfi" G
Sinned: j _
COMMENtS
Date: 5104— �` REVIEWED ^L
89158'00" W
l ‘9,5:312,
25.0' ` r-, ,;
9 I on ,
n
:--,_7i
o o • Qui _ 3 t
o • r o
= 0 1 0 to
TYPE B DRYWELL , .
W/ TYPE 4 METAL I u_
FRAME AND GRATE •o Y ,p
RIM EL = 2056.00 f
STA 2+95, RT 30' I •"\. •
• I
• -SWALE F- 1
30.0'
I
STA 2+90.89 (p ' 1
EL = 2056.42S 89'58 007 W
STA 2+82.89 95.17' •
EL = 2056.43
(2) CURB DROPS 4.0'
W/ 2'-3" OPENINGS •
c-I DRAINAGE "208' SWALE
EASEMENT BOTT EL = 2055.50
tri BOTT AREA = 750 S.F.
crl g
5' ,G��7
2' 1 2' _ I 30' 2' 3'
0.75'
iiiiiioiiiiiiiiiiiiii ,0';• %"0 •" -., 10.50' ,,, 1
► .
SWALE SECTION g,,' A�
`� NTS I—
►'•I/- o
28247 W 111
0 15 30 60 1. I _,�.p
�\'J �+�• ��, 3• STE '�'ti =
VALLEY PINES SUBDIVISION ZONAL EIl Dp rn
1 inch = 30 ft. LOT 2 — BLOCK 1 EXPIRES 12 15 00 6
z
HAHN ENGINEERING N. 8623 SUITE B DIVISION SPOKANE, WA. 99208 o
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