2005, 04-13 Permit App: 05001169 RemodelProject Number: 05001169 Inv: 1
Application
Date: 04/13/2005 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FINISH BASEMENT - (3) BEDROOMS, FAMILY Contact: LEVCHENKO, PAVEL & ZOVA
ROOM, BATH & UTILITY ROOM Address: 16017 E 5TH LN
C - S - Z: SPOKANE VALLEY, WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509) 891-5705
Group Name:
Site Information: Project Name:
Plat Key: 005862 Name: SHELLEY LAKE PUD District: East
Parcel Number: 45242.1605
SiteAddress: 16017 E 5TH LN
Location:: CSV
Block: 6 Lot: 5
Zoning: UR -3.5 Urban Residential 3.5
Water District: 010 VERA
Owner: Name: LEVCHENKO, PAVEL & ZOVA
Address: 16017 E 5TH LN
SPOKANE VALLEY, WA 99037
Hold: ❑
Area: ',757.00 Acres Width: 67 Depth: 115 Right Of Way (ft): 30
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Plan Review
Permits:
Contractor: OWNER
Building Permit
Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT R R-3 VB BASEMENT 0 $10,000.00 0 $10,000.00
FINISH
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Totals: 0 $10,000.00 0 $10,000.00
Units Unit Desc Fee Amount
1 SELECT $181.25
I SELECT $4.50
1 SELECT $72.50
Permit Total Fees: $258.25
Operator: K_C Printed By: K_C Print Date: 04/13/2005
Project Number: 05001169 Inv: 1
Applicatiaon
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 04/13/2005
Mechanical Permit
Page 2 of 2
Contractor: OWNER Firm: OWNER
Phone: (000)
Item Description
VENTILATING FANS
Units Unit Desc
2 NUMBER OF
Permit Total Fees:
Plumbing Permit
000-0000
Fee Amount
$20.00
$20.00
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Item Description
TOILETS/BIDETS
SINKS
SHOWERS
Notes -
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Fee Amount
$6.00
$6.00
$6.00
$18.00
OCCUPANCY IS DENIED ON ALL LOTS UNTIL FURTHER NOTICE FROM DIV. OF UTILITIES
PER GENE REPP 3/26/97 CKF OK TO ISSUE SEWER PERMITS FOR: BLOCK 2 - LOTS 3
THROUGH 10 & 1, 2 BLOCK 3 - LOTS 1 THROUGH 7 BLOCK 4 - LOTS 1 THROUGH 4
BLOCK 5 - LOTS 2 THROUGH
6 & 19 BLOCK 6 - LOTS 1 THROUGH 10
Payment Summary:
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$258.25
$20.00
$18.00
Invoice Amount
$258.25
$20.00
$18.00
Amount Paid
$0.00
$0.00
$0.00
Amount Owing
$258.25
$20.00
$18.00
$296.25 $296.25 $0.00 $296.25
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: 04/13/2005
S°pokane
#Valley
w
BUILDING PERMIT APPLICATION WORKSHEET
E cc�fv afalley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
ne: (509) 688-0036; Fax: (509) 688-0037
APR 0 4 2005
UaDON
REQUIRED SITE INFORMATION
Street Address: /,6d/7f•S"Vane 2•j/. f903? -
Assessor's Tax Parcel Number(s):
Legal, Description: • •
PERMIT DESCRIPTION:
tr Building Permit
Relocation
AAS I-3 3(0X z-7
❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: f�Qrd je vc,#L ,Ga
Phone: ,Qq/ S729,i Fax:
Address: ;a44 -1.e es aA,R-
City
State
Applicant:e
Phone: Fax:
Address:
Zip Code City
State Zip Code
Contractor: ❑ Architect:
Phone: Fax: Phone: . Fax:
Address:
Address:
City
State
Zip Code City
State Zip Code
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
• 3Es Z- ?-
# OF STORIES:
MAIN F.LOOR.TO SQ. FTG::.
...2"?. FLOOR SQ. FTG: :
-UNFIN'BASEMENT SQ. FTG:
FINISHED BASMMSQ. FTG:
GARAGE SQ. FTG:
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COS OF PROJECT:
®' DD '
30%SLOPES ON PROPERTY:
SEWER OR ON-SITE SEPTIC.
SYSTEM? kGee�r.
MANUFACTURED HOME
Width:
1 e
Length: ' Year: Pit Set
Manufacturer
. RELOCATION
... , i
Previous Address:
Proposed Use:
n
,
,ti
FIRE SAFETY
Fire Sprinkler
Tent: •
Valuation: •
# of Heads: Fire Alarm:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner: Phone: Fax:
Address:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
❑ BOLTING
Firm Name:
0 CONCRETE 0 REINFORCEMENT
Phone:
I nspector(s):
Fax:
❑ WELDING
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 reviewat 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 �d/evel/op�me�nJt rights granted lly. any issti4d permit inur
Print Name '6V' 8/ !.+✓T'p�t 4 deo Signature
the property owner.
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash •
Et Check 0 Mastercard
❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Cali (509) 688-0054
Community Development Department
Building Division
11707 E, Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Project Address: X60/7 5f ''4h:m e / • v. 4110Permit Use:
Owner. fr#vt/ LevedLe lLt o Phone (Daytime Contact):W?- S q/-S.7Bf
Mailing Address: . S'd '+f
Contractor. geione
Mailing Address:
City
License #:
State Zip Code
Phone #:
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1 OF UNITS
X
. COST •
_
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS'
1
X
- 36.00.
2
URINALS
X
S$.00
=
3
TUBS .. .—'
I
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT • .
X
56.00
=
5
•
SINKS
LAVS/6ASINS, BAR, FLOOR, KITCHEN,
'LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, .PREP/CULINARY MEAT
I
1
X
38.00
=
6
DISHWASHER
X'
36.00
7
CLOTHES WASHER
X
' 36.00
=
8
GARBAGE DISPOSAL
X
56.00
=-
9.
WATER SOFTENER
X
16.00
=
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
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATON, ALTERATION, REPAIR
. REVERSALS
X
36.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER HOSE BIB,
STEAMER
PROOFER, CARBONATOR 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
36.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
5600 '
=
20
MISCELLANEOUS PLUMBING
FIXTUREX
16.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
.
X
120.08
=
22
INDUSTRIAL WASTE .
INTERCEPTOR
X -
515.00
-
• _
•
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
bATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
. 135.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
a '^
'MECHANICAL PERMIT APPLICATION • ' Community Development Departmen
Building Dioisiol
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 101
For Inspections, Call (509) 688-0054 Spokane Valley, WA 9920(
. Project Address: Permit Use:
Phone (Daytime Contact):
Owner.
Mailing Address:
Contractor.
Mailing Address:
License #:
City
state
Phone #:
Zip Code
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
*OF UNITS
X
DOST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
912.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
315.00 .
_
3
UNLISTEDAPPLIANCE (Additional Fee) •
Equal to or less than 400.000
X
550.00
4
UNLISTED APPLIANCE (Additional Fee) '
More than 400,000
X
3100.00
=
5
USED APPLIANCE (WSEC min. AFUE tating)
Equal to.or less than 400,000
' X.
350.00
=
-
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400 000
X '.
S100.00
=
• 7
BOILER/REFRIGERATION
1: 100M BTU
- X
312.00
6
BOILER/REFRIGERATION
101 - 500M BTU
X
320.00
=
9
BOILERJREFRIGERATION
501 - 1,000M BTU
X
325.00
=
10
BOILER/REFRIGERATION
1,001 -1 750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
360.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
• 310.00.
=
13
RANGE
•X
310.00
=
14
DRYER
X
510.00
=
15
i
FUEL BURNING WATER HEATER
X
310.00
=
'
16
MISC. FUEL BURNING APPLIANCE '
I
X
310.00
=
17
GAS PIPING (each outlet)
X
31,00
=
16
DUCT SYSTEMS
X
310.00
19
VENTILATING FANS
' '
'
X •
910.00
=
20
AIR HANDLER (DOES NOT include ducting)
. Equal to or less than 10,000 CFM
X
$1200
=
21
AIR HANDLER (DOES NOT Include ducting)
Greater than 10,000 CFM .
_
X
315.00
=
22
EVAPORATIVE COOLERS
.X
310.00 •
=
23
TYPE I HOOD
X
350.00
=
24
TYPE II HOOD
X
310.00
25
HEAT PUMP/AIR CONDmONER •
0-3 TON
• .
X
. . 312.00
- _
26
.AIR CONDITIONER'
3-15 TON
I X
920.00 .•
._
27
AIR aNDITIONER
15-30 TON
X
925.00.-
=
26
AIR CONDITIONER
- 30-50 TON
X
335.00 .
_
29
AIR CONDITIONER
More than 50 TON
X
360.00
=
30
LPG STORAGE TANK
X
310.00
=
31
WOOD OR PELLET STOVE/INSERT .
X
310.00
32
WOOp STOVE - FREE STANDING
X
525.00
=
33
REPitIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS
X
' 312.00
=
35
VENTILATION MECHANICAL EXHAUST
X
312.00
_
36
INCINERATOR - RESIDENCE (
X .
319.00 '
=
INCINERATOR - COMMERCIAL
X
- 322.00
=
.37
METHOD OF PAYMENT:
' 0 CASH 9 CHECK 0 VISA 0 MC
CARD a:
DATE
SUBTOTAL
'PROCESSING FEE
335.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
1
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1 1
1 L_A
1
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