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2005, 08-11 Permit App: 05002877 Remodel
Project Number: 05002877 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/11/2005 Page 1 of 3 Project Information: Permit Use: REMODEL - ADD BEDROOM, BATH, 2 -CAR GARAGE U 11 Setbacks: Front (: N Left: 41' Right:2C 9 Rear: �/ $ Site Information: Plat Key: 003703 Name: BEARS ADD Contact: BELCHER, LARRY Address: P.O. BOX 14098 C - S - Z: SPOKANE, WA 99206 Phone: (509) 924-8896 Group Name: Project Name: District: Nort Parcel Number: 45173.1224 Block: SiteAddress: 206 N WILLOW RD Location:: CSV Zoning: UNKN Unknown Water District: Lot: Owner: Name: BELCHER, LARRY Address: P.O. BOX 14098 SPOKANE, WA 99206 Hold: ❑ Area: .00 Acres Width: 0 Depth: 0 Right Of Way (ft): 0 Nbr of Bldgs: 1 Nbr of Dwellings: 1 Review Information: Review Site Plan Review Plan Review Originally Released: 08/09/2005 By: TMELBOU Landuse/Zoning Sewer Review Permits: ReleasedBy:, SEWER PERMIT# 90004643 Originally Released: 08/11/2005 By: mturbak Operator: MT Printed By: MT Print Date: 08/11/2005 Project Number: 05002877 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/11/2005 Page 2 of 3 Contractor: OWNER Group: R-3 Type: VB Total Area 400 Building Height 14 Stories 1 Dwelling Units 1 Building Permit Firm: OWNER Phone: (000) 000-0000 Building Characteristics Description Grp Type Notes DECK R-3 VB GARAGE U-1 VB RES ADD R-3 VB Item Description RESIDENTIAL PERMIT FEE STATE SURCHARGE RESIDENTIAL PLAN REVIEW Contractor: OWNER Item Description VENTILATING FANS Contractor: OWNER Item Description TOILETSBIDETS SINKS SHOWERS Totals: Units 1 1 1 This Application: Total Project: So Ft Valuation Sq Ft Valuation 192 $2,880.00 192 $2,880.00 528 $10,032.00 528 $10,032.00 400 $29,872.00 400 $29,872.00 1,120 $42,784.00 Unit Desc SELECT SELECT SELECT Permit Total Fees: Mechanical Permit 1,120 $42,784.00 Fee Amount $573.05 $4.50 $229.22 $806.77 Firm: OWNER Phone: (000) 000-0000 Units Unit Desc 2 NUMBER OF Permit Total Fees: Plumbing Permit Firm: OWNER Phone: Units 1 1 1 Operator: MT Printed By: MT Unit Desc NUMBER OF NUMBER OF NUMBER OF Permit Total.Fees: Fee Amount $20.00 $20.00 (000) 000-0000 Print Date: Fee Amount $6.00 $6.00 $6.00 $18.00 08/11/2005 Project Number: 05002877 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 08/11/2005 Page 3 of 3 Notes: Payment Summary: Permit Type Building Permit Mechanical Permit Plumbing Permit Fee Amount Invoice Amount $806.77 $20.00 $18.00 $806.77 $20.00 $18.00 $844.77 $844.77 Amount Paid $0.00 $0.00 $0.00 Amount Owing $806.77 $20.00 $18.00 $0.00 $844.77 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: MT Printed By: MT Print Date: 08/11/2005 BUILDING PERMIT APPLICATION WORKSHEET CITY(dine City of Si) me Valley, Community Development Department 1�(f C Building Division 1 11707 E. Sprague Avenue, Suite 106 4000lle '� �-- Spokane Valley, WA 99206 (.fhone: (509) 688-0036; Fax: (509) 688-0037 RE RED SITE INFORMATION u - (Z. P Street Address: oZ ©CO A/ t J \ \ o W Svo 041;10„W-1 Assessor's Tax Parcel Number(s): 1.15- t, 3 • t 2- 2. 4 Legal Description: ©PP Esau. 5 ti B 13) k 131 L7- /1 8 //r 2 exc. . T PERMIT DESCRIPTION: 74. r_ Moved\ - (IAA '10,jeg.o-orn -8(1441 QA4rD .2 C'O2 Itij Building Permit Relocation ❑ Change in Use n Grading n Manufactured Home ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: T 1e_ her Phone: q 2 k 4 -1 t Fax: Address: ,?o co to u. Li) T /920 co ity State Zip Code n Contractor: Phone: Fax: Address: City State WA State Contractor License #: Applicant�ioNi- Phone:9aci-` 6 Fax: Address: City State Zip Code ❑ Architect: Phone: Fax: Address: Zip Code City Contact: Spokane Valley Bus. Liscense #: Contact: State Zip Code PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: # OF STORIES: I MAIN FLOOR TO SQ. FTG; i 72- x 32_ - /l-c;L> 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: N/f-+ FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: * = 5,-? Sr DECK/COV, PATIO SQ. FTG: `6 XZ- = lq� OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: # OF BEDROOMS: 2 TOTAL H A�BITABLE SPACE: IMPERVIOUS SURFACE AREA: COST OF PROJECT: 0, Cco - 30% SLOPES ON PROPERTY: EWER OR ON-SITE SEPTIC YSTEM? MANUFACTURED HOME Width: Manufacturer: Length: Year: Pit Set: 1 RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Tent: Valuation: Paint Booth: Fireworks Display: Blasting: Date/Time: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Address: Phone: Fax: City State Inspector: Phone: Fax: Address: Zip City State Zip SPECIAL INSPECTIONS BOLTING Firm Name: CONCRETE REINFORCEMENT ❑ WELDING Phone: Inspector(s): Fax: DISCLAIMER The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the dwelling is/will be served by potable water. 2) Ownership of this City of Spokane Valley Permit inure to the property owner. 3) The signatory is the property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in full compliance with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) This City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. Ownership of resulting development rights granted by any issued permit inure to the property owner. Print Name Z.a. -TJ 43.-1 C.% Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash Check ❑ Mastercard ❑ VISA LJ Other Bankcard #: Expires: VIN#: Authorized Signature: %n ``De 1 ""`� MECHANICAL PERMIT APPLICATION Phone: (509) 688-0036; FAX: (509) 688-0037 • For Inspections, Call (509) 688-0054 Project Address: 20 (a Al • W -e.Thit v Owner. La..4--c--� 13.1. c4uA Mailing Address: Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Permit Use: Phone (Daytime Contact): City Contractor. License #: Mailing Address: State Phone #: Zip Code Ci State Zi Code AUTHORIZED SIGNATURE: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $12.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 = 3 UNLISTED APPLIANCE (Additional Fee) Equal to or less than 400,000 X $50.00 = 4 UNLISTED APPLIANCE (Additional Fee) More than 400,000 X $100.00 = 5 USED APPLIANCE (WSEC min. AFUE rating) Equal to or Tess than 400,000 X $50.00 = 6 USED APPLIANCE (WSEC min. AFUE rating) More than 400,000 X $100.00 = 7 BOILER/REFRIGERATION 1 - 100M BTU X • $12.00 = 8 BOILER/REFRIGERATION 101 - 500M BTU X $20.00 = 9 BOILER/REFRIGERATION 501 - 1,000M BTU X $25.00 = 10 BOILER/REFRIGERATION 1,001 - 1,750M BTU X $35.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X $60.00 = 12 GAS LOG, GAS INSERT, GAS FIREPLACE X $10.00 = 13 RANGE X $10.00 = 14 DRYER X $10.00 = 15 FUEL BURNING WATER HEATER X •$10.00 = 16 MISC. FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING leach outlet) X $1.00 = 18 DUCT SYSTEMS X $10.00 = 19 VENTILATING FANS 1 1 X $10.00 = 20 AIR HANDLER (DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 = 21 AIR HANDLER (DOES NOT include ducting) Greater than 10,000 CFM X $15.00 = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE 11 HOOD X $10.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12.00 = 26 AIR CONDITIONER 3-15 TON X $20.00 = 27 AIR CONDITIONER 15-30 TON X $25.00 = 28 AIR CONDITIONER 30-50 TON X $35.00 = 29 AIR CONDITIONER More than 50 TON X $60.00 = 30 LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 = 32 WOOD STOVE - FREE STANDING X $25.00 = 33 REPAIR & ADDITIONS X $15.00 = 34 VENTILATION SYSTEMS. X 512.00 = 35 VENTILATION MECHANICAL EXHAUST X $12.00 = 36 INCINERATOR - RESIDENCE X $19.00 = 37 INCINERATOR - COMMERCIAL X $22.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK 0 VISA 0 MC CARD #: DATE: SUBTOTAL PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: PLUMBING PERMIT APPLICATION Phone: (509) 688-0016;1FAX: (509) 688-0037 For Inspections, Call (509) 688-0054 Project Address. ,2O Co At c t7 -.421 -e r./ Owner. Acts -c-1 &wt. Mailing Address: .30 to At . (13 2.9.47 Contractor. Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Permit Use: Phone (Daytime Contact): 92c-•41 `t l C 0 oo kaw (aLQS tt�/ ci9.20 0 State Zip Code License #: Phone #: Mailing Address* City State Zip Code BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK S OF UNITS X COST . = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS / X 36.00 = 2 URINALS X 36.00 = 3 TUBS X 36.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ONSITE BUILT / X 36.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 1 X 36.00 = 6 DISHWASHER X 36.00 = 7 CLOTHES WASHER X 56.00 = 8 GARBAGE DISPOSAL X 36.09 = 9 WATER SOFTENER X 36.00 = 10 ELECTRIC HOT WATER TANK NOTE IF GAS, SEE MECHANICAL X 36.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 56.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X 36.00 = 13 FOUNTAINS, DRINKING X 36.00 = 14. WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR REVERSALS X 36.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 36.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, GARBONATOR, SWAMP COOLER X 36.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR VATS, TANKS, BOILERS X 36.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 36.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X 36.00 = 21 PRIVATE SEWAGE DISPOSAL SYS X 320.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 315.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK DATE SUBTOTAL 0 VISA 0 MASTERCARD PROCESSING FEE 535.00 EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: