2005, 03-09 Permit App: 05000713 Addition Project Number: 05000713 Inv: 1 Application Date: 03/09/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: ADDITION TO RESIDENCE-LIVING RM, Contact: ACCENT INTERIORS INC
LAUNDRY,SEWING RM&2 BATHS Address: 12402 N DIVISION#198
C-S-Z: SPOKANE,WA 99218
Setbacks:Front EXI Left: N/ Right: 10+ Rear: EX Phone: (509)466-5021
Group Name:
Site Information: Project Name:
Plat Key: 000498 Name: CORBIN ADD TO GREENACRES District: East
Parcel Number: 55202.0277 Block: Lot:
SiteAddress: 19004 E 4TH AVE Owner:Name: OTTO,FRED
Address: 19004 E 4TH AVE
Location::CSV SPOKANE VALLEY,WA 99016
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 68,740 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review In formation: MSP ..M,0, VOW. ......7 *y.. -...MP'`` s., '' . -:.. r_ --. = a .-.::sr, .-ox, 1.40.-
Review
. -.mReview _ --- -- -Site Plan R v' w ( Ad L D'eleased''By:
- 1.
Plan Review -- '''''` R-=aced B '
T
40.49L
1 Ya tic System Review Released By: A ( r ,,
Permits: ,:: 0-1 - res .. $,L .- ;a _- . ..Wig,. t
Operator: K_C Printed By: K_C Print Date: 03/09/2005
03/11/2005 09:55 5093241567 SRHD EHS PAGE 01
MAR 09 20005 12:03 FR TO 3241567 FAN/03
Project Number: 05000713 Inv: 1 Application Date: 03/09/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Proud Jteforinajfn: milmmonwpoimaliginnensimimimir 110111101am=Mis�IMEMEIRMO""'
Permit Use: ADDITION TO RESIDENCE-LIVING RM, Contact: ACCENT INTERIORS INC
LAUNDRY,SEWING RM 14t 2 BATHS Address: 12402 N DIVISION#198
C- -Z: SPOKANE,WA. 99218
Setbacks:Front EXI Left: N/ Right: 10+ Rear: EX Phone: (509)466-5021
Group N'�amo:
Project Name:
Site Informatiarta
-willese,maneammemspoamo..ritww
Plat Key: 000498 Name: CORBIN ADD TO GREENACRESi • trict: East
Parcel Number: 59202.0277 Block: Lot:
SiteAdi rens: 19004 E 4TH AVE Owner:Name: :OTTO,FRED
Address: k19004 E 4TH AVE
Locution::CSV SPOKANE VALLEY,WA 99016
Zoning: UR-3.5 Urban Residential 3.5
Wager District: Bold: ❑
Area: 68,740 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr o:f Owcilings: 1
$evirewInfornualii assammisammasommsauswassasammatessamsamrsomommewommamememassamassacwissigsgaisse.
Site Plan Review �....(. is
.
Plan Revie9'YBLyJ, CµIC,RTS•,('S'~ �s lla.,,gl .., ..VY��N:17i , ..•'(
Septic System Review ks; .,, t �,: .
_Z±K.lee iKinrarr d 7- -
Ferinlr, :
.immmemiwmpigwiMlipMiMMMMSMNMMIIIIIMIIIIIMIIIMmmmiMIIMMIIMIIaaiiesM..Mr
Operator: K,C Printed By: Ks Prue Date: 03/09/2005
• f
MAR 11 2005 10:02 5093241567 PAGE.01
Project Number: 05000713 Inv: 1 Application Date: 03/09/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: ACCENT INTERIORS INC Firm: ACCENT INTERIORS INC
Address: 12402 N DIVISION ST,SUITE 198 Phone: (509)466-5021
SPOKANE,WA 99218
Building Characteristics
Group: R-3 Type: VB
Total Area 832
Building Height 0
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT F R-3 VB 416 $8,320.00 416 $8,320.00
RESIDENCE R-3 VB 416 $31,066.88 416 $31,066.88
Totals: 832 $39,386.88 832 $39,386.88
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $542.75
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $217.10
Permit Total Fees: $764.35
Mechanical Permit
Contractor: R&R HEATING&AIR COND INC Firm: R&R HEATING&AIR COND INC
Address: 4019 E CENTRAL Phone: (509)484-1405
SPOKANE,WA 99207
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00
VENTILATING FANS 2 NUMBER OF $20.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
Permit Total Fees: $75.00
Operator: K_C Printed By: K_C Print Date: 03/09/2005
Project Number: 05000713 Inv: 1 Application Date: 03/09/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: THAISS PLUMBING& Firm: THAISS PLUMBING&SPRINKLE
Address: 3935 N NAPA ST Phone: (509)487-2703
SPOKANE,WA 99207
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 2 NUMBER OF $12.00
SINKS 2 NUMBER OF $12.00
SHOWERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
Permit Total Fees: $36.00
Notes :s ":A.....,".. `"',:�- .: .�..:... .'q-':`':="- Hl. ""� i`AWL''gc:rt- ^,:..- t ! " , :::mar .._ ,..,..::,...�....�. � .;:.......,a. :.s:%
Payment Summary: ,µ:men � zongspromer . ,.a ._
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $764.35 $764.35 $0.00 $764.35
Mechanical Permit $75.00 $75.00 $0.00 $75.00
Plumbing Permit $36.00 $36.00 $0.00 $36.00
$875.35 $875.35 $0.00 $875.35
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: K_C Printed By: K_C Print Date: 03/09/2005
x > P � ING PERMIT APPLICATION WORKSHEET
Cu (X' . - City of Spokane Valley Community Development Department
pokalle \ii BuildingDivision
' 11707 E. Sprague Avenue, Suite 106
4000Valle r Spokane Valley, WA 99206
Y Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: / 166 V /� c�2�� , L fol‘
q
Assessor's Tax Parcel Number(s): ' ---5---9'0,;Z , il t> '
Legal Description:
PERMIT DESCRIPTION: _ (j1tY1 cYj,1,1�ti r ,N pit:.
wilding Permit ( I Change in Use U L-
g ❑ Grading n Manufactured h-p i,�
n Relocation Tenant Improvement I .1 Fire Safety n Other
OWNER/APPLICANT INFORMATION
Owner: O Th / of N '---(11/041 n Applicant:
Phone: / Fax: Phone: Fax:
Address: / gra o c,t , - � Address:
' Pi 4' ,fog £L, - g90"(.
City / State Zip Code City State Zip Code
[ - Contractor: 4 c c t.,,,--Kort / n I I Architect:
Phone: 6 e; .rz 7,c Fax: 4E6 6 S -76v Phone: Fax:
Address: Address:.
City State Zip Code City State Zip Code
WA State Contractor License #: ,V EZ()91 [Contact: Qo,l 9- 1
allQ p 0
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
s3�.0 As yi 4/ 4,e
/A Y ZC 4Dfn, ,t / (, r A�yvt,
MAIN FLOOR TO SQ. FTG: 1 2Nu FLOG SQ.FTG: UNFIN BASEMENT SQ. FTG:
tilt
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: . DECK/COV. PATIO SQ. FTG:
OCCUTZNCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
. F-4 n�r Ltj
•
# OF BEDROOMS: TOTAL HABIJABLLEE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM?
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 (1 CONCRETE ❑ REINFORCEMENT in 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)
n Cash *heck ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature: r/c,/,/
PLUMBING PERMIT APPLICATION Community Development Department
lir!I Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
dAa,ley For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: d0 / , j � ?
. , _ Permit Use:
Owner: O]�f ¢� -4 cid0., Phone (Daytime Contact):
Mailing Address: , S4 kg
/� f\( " State Zip Code
Contractor: jc('S, ��Ni e . x Phone#: 06'50ZI
Mailing Address: /2 /a A) . 13,727,57- ,)- 9g 759 4 l b0/9" 9 2/8
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X .COST• = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X • $6.00 =
2 URINALS X $6.00 =
3 TUBS /f 0 X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ONSITE BUILT • r X $6.00 =
• LAYS/BASINS,BAR,FLOOR,KITCHEN, r
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, 02, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER X $6.00 =
7 CLOTHES WASHER X $6.00 =
B GARBAGE DISPOSAL X $6.00 =
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,CONDENSATE X $6.00 =
'ROOF DRAINS/OVERFLOW
12 DRAINS X $6.00 =
13 FOUNTAINS,DRINKING X $6.00 =
WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR,
14 VENT,PLUMBING,REVERSAL .REVERSALS X $6.00 =
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER X $6.00 =
PROOFER,CARBONATOR,SWAMP COOLER
VACUUM BREAKER,CHECK VALVE,
17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 =
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = •
MISCELLANEOUS PLUMBING
20 FIXTURE . X $6.00 = • •
21 PRIVATE SEWAGE DISPOSAL/SYS X _ $20.00 _ =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD .00
• DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: •
/'� MECHANICAL PERMIT APPLICATION Community Development Department
sookar' \ Building Division
liL, Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
olVa
1C}r For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: • Permit Use:
Owner: Phone (Daytime Confect):
Mailing Address:
l' ��''Q-� City State Zip Code
Contractor: R- lat7License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST . = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 J 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 less 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/REFRIGERAT1ON 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(each outlet) X $1.00 =
18 DUCT SYSTEMS X $10.00 = •
�}
19 VENTILATING FANS 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 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 0R PELLET STOVE/INSERT X ' $10.00 =
32 •WOOD STOVE-FREE STANDING X $25.00 =
33 REPAIR d ADDITIONS X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00
36 INCINERATOR-RESIDENCE ' X _ $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL
❑CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE .00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
07-To)
Fid ,- EQ , t-14 bc,N RA PP 0 AL.P1 rLe
• Igoo c C q11-1
-'(2e &iti A c_nes1 Wit 9to/6
P7Lor Ptak)
442t. 1
(P ,-i(S A
bik 1 °,\\)
(Doc)M e—
f t'' (4)4,otrci:t ,t,
.6s' I
16 jiirt:;
, — ,-2 St) — ilkiplity:
. . , if
''''' 417H- i,A V EA) ti J2- .
L44*****41*144:44S1
fnie/e4ttdea
Y'L. ^oOqr. W for I
.`eke ' es St se. q//a tr4ee'��ra
` . ep St so i vot4r k7o aIQ ose f
open rya'. tees anry n pry orreL'/
ZONE V '"� :cote: F
ROADi\i
' 1_ the are �s•q�oer,Y
FRONT CA . FLAWING ��r�'ai���a�a to
coMM0wrs < ,i as.REVIEWED - ti�/7/it.