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2004, 04-19 Permit App: BLD-04-04118 Residence simanoee\i„ 40,00Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206. .., Phone:(509)688-0036 Fax:(509)688 0037 • REQUIRED SITE INFORMATION STREET ADDRESS: S L,d l,•- G 7' ASSESSOR'S TAX PARCEL NUMBER(S): LEGAL DISCRIPTION: pr- / / Q LOGS / /9 L of P1 /9i90 PERMIT DESCRIPTION: . ' . . .DNTG•PERMIT • -CHANGE.IN USE C GR DING CT FACTURED-HOME D-RELOCATION . D-SIGN . ®-TENANT a-OTHER ... • OWNER / APPLICANT INFORMATION .1 El OWNER: / /1/2r Ler/V5TEl-GT//a't> (3 APPLICANT: PHONE: so?-53.5--8377/t FAX: 517 y V2-3�/ PHONE: FAX: ADDRESS: 3 1'2 9. S /K (4094. /60 ADDRESS: ' w/01/(/‘/ ,q 9q'2z ITY,STATE,ZIP .. CITY,STATE,ZIP CONTRACTOR: ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,.STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# P/9/2./45 GS/G y k S CONTACT: PERMIT/BUILDING INFORMATION COST OF PROJECT: 3/000 30%SLOPES ON PROPERTY: /JD MAIN FLOOR SQ FT: /.3.3f> BUILDING HEIGHT TO PEAK: 2.0 OCCUPANCY GROUP:. S/v4L t `r is-r 2ND FLOOR SQ FT:- fife:9 r,e' BUILDING DIMENSIONS: 4OiSS CONSTRUCTION TYPE: wovYJ /-&i-y, UNFIN BASEMENT: AA" 'NUMBER OF STORIES: / STRUCTURES ON PROPERTY: /f."Il FINISHED BASEMENT: AV©IV C NUMBER of BEDROOMS: 3 CRITICAL AREAS: ,[.9D GARAGE: yyp FLANKING SETBACK: CURRENT PROPERTY SIZE: (O.6 L/ COVERED DECK: Ndwe--- FRONT SETBACK: 3 7 CURRENT PROPERTY USE: VALvfwr DECK: /007414" REAR SETBACK: 2. 1 CURRENT SEPTIC USE: '/U9� N LEFT SETBACK: 2 7 CURRENT WELL USE: o / RIGHT SETBACK: 7 IMPERVIOUS SURFACE AREA: • • *aTY< 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone mane Spokane Valley,WA 99206 509-688-0037-Fax � �T For Inspections, call 509-688-0054 -Mechanical Permit Application PROJECT PERMIT ADDRESS: 7/0 �j to/i4v/2 e„„7 USE: . OWNER p'w .,s Co, ,97-e scri et/ PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR: LICENSE I: MAILING ADDRESS: PHONE I: (street) (city/state) (ZIP) • DESCRIPTION OF WORK 4 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<100,000 I X $15 • - 15 2 FUEL BURNING APPLIANCE _ >100,000 X $19 - 3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR<400,000 • X $50 - 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X 5700 - 5 USED APPLIANCE(WSEC min.AFUE raking) .or<400,000 X $50 - 6 USED APPLIANCE(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 $39 - 10 BOILER/REFRIGERATION 1001 1,750M BTU X . $57 11 BOILER/REFRIGERATION +1750M BTU X S95 - 12 GAS LOG,GAS INSERT,GAS FIREPLACE - I X $10 - / o 13 RANGE - X 510 - 14 DRYER - X $10 - 15 FUEL BURNING WATER HEATER - ' X $10 - /C 16 mac FUEL BLERNINGAPPL - X $10 17 GAS PIPING(ea.Outlet) - J X $1 .. / 18 DUCT SYSTEMS - • X $10 - 19 VENTILATING FANS 3 x $10 3 Q 20 AIR HANDLER(DOES NOT include ducting) -OR<10,000CFM X 512 - 21 AIR HANDLER(DOES NOT include ducting) >10,000 CFM X $19 - 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 24 TYPE II HOOD - / X S10 - ' a 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 525 - 28 AIR CONDITIONER 30-50 TON X $35 - 29 AIR CONDITIONER +50 TON X $60 - 30 LPG STORAGE TANK - X $10 - 31 WOOD OR PELLETSTOVE/INSERT _ - X $10 32 WOOD STOVE-FREE STANDING -. X S25 - SUBTOTAL 7G 6 METHOD OF PAYMENT PLUS PROCESSING FEE $35.00 VISA' .12 .• TOTAL PERMIT FEE DUE: 1//r o4, ❑ CASH ❑ CHECK ❑ MOM 0 • DATE: EXPIRES: • BANKCARD NUMBER: AUTHORIZED SIGNATURE: ��++or:<rpU �� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone ' ►_7nkae Spokane Valley,WA 99206 509-688-0037-Fax . *Valley For Inspections, call 509-688-0054 alley Plumbing Permit Application PROJECT PERMIT ADDRESS: 7/e S u ' jj7r e._. `/ USE: OWNER P4111,94 6-d,N5 71/vGT/e*, PHONE(Daytime Contact): MAILING ADDRESS: • (street) (city/state) (ZIP) CONTRACTOR: NAV/ LICENSE#: MAILING ADDRESS: PHONE#: • (street) (city/state) (ZIP) • • • ' PLUMBING FIXTURES DESCRIPTION DETAILS #OF IIlVITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS Z X $6 - / 2 2 URINALS X $6 - 3 TUBS I- X $6 - 6' 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 G 5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- 3 X $6 - RAY,FOOD,PREP/CULINARY/MEAT /I 6 DISHWASHER / X $6 - 6 7 CLOTHES WASHER • / X $6 - 6 . • 8 GARBAGE DISPOSAL I X $6 - L 9 WATER SOFTENER • X $6 - 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL . X $6 - 11 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 $6 - R.P.B.P.D.FOR VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM X $25 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL • X $6 HOLDING TANK 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - IETHOD OF PAYMENT SUBTOTAL 0 MOM ' •'ire$_ PLUS PROCESSING FEE: $35.00 ] CASH ❑ CHECK ❑ ❑ _ r=..1 TOTAL PERMIT FEE DUE: 9 S, 0r) ATE: EXPIRES: I 4NKCARD NUMBER: JTHORIZED SIGNATURE: pL or P i91v________- __ 40 4.0 7/g S WJ_ -�1.v.g.__._c7 co `Ao k'O 2• ., 9 F , . IL.OT I __8L oG/c _1mi LE'/IF/ �Lr �FO� � iMt EAiv_ L/4T4-i .Dvsvey SEie,EA yamti/33 a 5.F. ..9A14/15/1- .4** AN .y , 87.40 0 ,;- ZS, ) ,:\111j- 1/4, 14r160(‘'U'L • CP Z ' A 0 ukil)-NA % --.. Ni \Li/7 li% f 70 T Sar ,T 1„ � 2-O , Lo Iva— e"'” a N lam„' n M This site plan is being submitted fort the purpose Of obtaining a building permit and Is a true and correct representation of the proposal. AN known property lines/dimensions,curb lines,structures and easements have been identified. Also indicated are wetlands. / Z 3$.70 bodies of water,, steep slopes or other critical areas. to•q 7 Signed:.2-Sa____ .,t ( f Date: `} 2 e-131-