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2004, 07-02 Permit App: BLD-04-07241 Residence • , • BUILDING PERMIT APPLICATION WORKSHEET a City of Spokane Valley Community Development Department Ca Building Division .000Vall 11707 E. Sprague Avenue, Suite 106 e Spokane Valley, WA 99206 Phone: (509) 688-0036;Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: I eh? `f -� Assessor's Tax Parcel Number(s): 6175- 02.- 0-2 %'�' Legal Description: C ( b i 11 ACU 60 Cv-e f CtC ,r es 'TQ A 5f° 1-.. PERMIT DESCRIPTION: (:tSE ATrlccikv CD A- PSE, Building Permit D Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION EK Owner: K-6.0 put C GU ❑ Applicant: SfhtIC Phone: 11(-6Ss7 9 Fax: ? 2,Y-370 Phone: .9 Fax: Address: /7-0 4 ns.. A•2Tc E1 c r y r -ss: s�F c,gke- if��(LH, LAJP{ 9/0a `� I \�� ` 4y p City State Zip Code `Q V C W •C�'p91 Zip Code ❑ Contractor: S � SS 4Arc t: \ ���00 46. � Phone: Fax: V , t 1. Ph ,���0w Address: • ;�. o4Q \�0 D _ City State Zip 0 Q City State - O ' ode WA State Contractor License #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: I c g s` S-x, Lir #OF STORIES:/ MAIN FLOOR TO SQ. FTG: 2""FLOOR SQ. FTG: UNFIN BAS ENT SQ. FTG: Z� � o'0 ' r_ ., l,0 o FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: K � CONSTRUCTION TYPE: HEAT SOURCE: #OF BEDROOMS:/5 5- TOTAL HABITABLE SPACE: IMPERVIOUS SURF E AREA: 9-000 COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC 7 010 0© r.-Q- SYSTEM? $ r(c- 65 , • MANUFACTURED HOME Width: Length: Year: Pit Set: Manufacturer: RELOCATION Previous Address: Proposed Use: FIRE SAFETY Fire Sprinkler: # of Heads: Fire Alarm: Paint Booth: Tent: Fireworks Display: Blasting: Date/Time: Valuation: Above/Underground Storage Tank Size: WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE Plans Examiner: Phone: Fax: Address: City State Zip Inspector: Phone: Fax: Address: City State Zip SPECIAL INSPECTIONS ❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING Firm Name: Phone: Fax: Inspector(s): 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 Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash El Check ❑ Mastercard ❑ .VISA ❑ Other Bankcard#: Expires: VIN#: Authorized Signature: MECHANICAL PERMIT APPLICATION rrtt� City of Spokane Valley Community Development Department BuildingDivision \r/z Tnp lie 11707 E. Sprague Avenue, Suite 106 4110" Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 FOR INSPECTIONS, CALL(509)688-0054 Project Address: / c,, Permit Use: Owner: >; N-7 R./61* Phone(Daytime Contact): 9 p 1--ss---1 9 Mailing Address: i r-o9 nJ. 4,z rtS CT• (-,2, -)&c-f2^-i1(Af - 9'9016 City State Zip Code Contractor: C- License#: Phone#: Mailing Address: City State Zip Code #OF TOTAL DESCRIPTION OF WORKUNITS X COST = AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $15.00 = 2 FUEL BURNING APPLIANCE More than 100,000 X $19.00 = 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 = USED APPLIANCE(WSEC min.AFUE 5 rating) Equal to or less than 400,000 X $50.00 = USED APPLIANCE(WSEC min.AFUE 6 rating) More than 400,000 X $100.00 = 7 BOILER/REFRIGERATION 1-100M BTU -X $15.00 = 8 BOILER/REFRIGERATION 101-500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501-1,000M BTU X , $39.00 = 10 BOILER/REFRIGERATION 1,001-1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 , 12 GAS LOG,GAS INSERT,GAS FIREPLACEX $10.00 = 13 RANGE 1 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(each outlet) q X $1.00 = 18 DUCT SYSTEMS X $10.00 __ 19 VENTILATING FANS5 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 $19.00 , = 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $50.00 = 24 TYPE II 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 = METHOD OF PAYMENT: SUBTOTAL 0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00 CARD#: EXPIRES: TOTAL PERMIT FEE DUE: 116.00 AUTHORIZED SIGNATURE: • • •• PLUMBING PERMIT APPLICATION Q City of Spokane Valley Community Development Department Sifiiall°1 �+ BuildingDivision \ 1eY 11707 E. Sprague Avenue, Suite 106 411110 Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 FOR INSPECTIONS, CALL(509)688-0054 Project Address: / k. c . (1Tx Permit Use: Owner: 1K,c- p tU G7( Phone (Daytime Contact): / h_ S-5-(7 Mailing Address: / 2-.1' A): 4-fe_5(C-r CT. 67 E JCJ2-S1 c,J Pr 9 9 0 t City State Zip Code Contractor: - 5 E License#: Phone#: Mailing Address: City State Zip Code *OF TOTAL DESCRIPTION OF WORK UN JS X COST - AMOUNTt 1 TOILETS WATER CLOSET,BIDETS `"�� X $6.00 = Z r 2 URINALS X $6.00 = 3 TUBS 2- X $6.00 = / 2- 4 SHOWERS(PER TRAP) BATH,STALL ON-SITE BUILT / X $6.00 = , 5 SINKS LAVS/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, q X $6.00 = cs—� JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT _ 6 DISHWASHER jX $6.00 = efJ / 7 CLOTHES WASHER X $6.00 = �c^ 8 GARBAGE DISPOSAL 1 X $6.00 = C 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, 1 X $6.00 = CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, // HOSE BB,STEAMER,PROOFER, X $6.00 = Z`f CARBONATOR,SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR: X $6.00 = VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK , 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: SUBTOTAL ❑ CASH 0 CHECK 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: (7 7.00 BANKCARD NUMBER: AUTHORIZED SIGNATURE: 4 ► r..1 Public Viewer-[Plat Irnage Search Results] [ fI ;' C.i 0710 i Short let 9308030614 i 0810311993 - 20-25-45-2 t_,f .• - 76860 02054222, II �,l i " 1 ��; imp®j SP-0710.91 Plat Ma. 1 9� 111iLW1 r...tithe afore 1-" • Fourth IfA5t gas@.IEiE84@y.�ItiRac7 Ave. this.Z.7_day o!,_ is to A regi-toae� a 2 3d a".scla4.:rt ava.ro—_"_room—.—%11_1. s 11_1- --t 14°.o ,4 - si'�xLI :, a .. a" 1 Lair] er"" •--r— (ars�e+a4 i laem,L. 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