2004, 07-28 Permit App: BLD-04-07185 Addition BUILDING PERMIT APPLICATION WORKSHEET
SCIT1City of Spokane Valley Community Development Department
polianeBuilding Division
11707 E. Sprague Avenue, Suite 106
400,ValleY Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: / '70 7 / 7G
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION: ,�}/N9) r; 0 ,t/ To J' T J/j,, ,../
(Building Permit 7 Change in Use n Grading _ Manufactured Home
1 f Relocation n Tenant Improvement U Fire Safety Other
OWNER/APPLICANT INFORMATION
Owner: An-old Jti iJ11.6,4-04,/ pi Applicant:
Phone: ?1.y -;4-cm Fax: Phone: Fax:
Address: G 7.'] 1._d_ Address:
5,42f ,j 1 11 A;y 9 9/i 1.---
City
vCity State' Zip Code City State Zip Code
Hr Contractor: /1/11 f=.Ui n-Az,sh _ Architect:
Phone: 7y7-ASSL3 Fax: c 3i/-yyi3" Phone: Fax:
Address: y10/y t,/ r`y,d Address:
,ogirAii; 9 9Jc7'/
City State Zip Code City State Zip Code
WA State Contractor License #: /f Jj jw, 777. y `/tai)/¢Contact: /-1 //I it j i1 .-
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: /� i DIMENSIONS: #OF STORIES:
MAIN FLOOROQ,�FTG: 2"" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE 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 n CONCRETE 1 l REINFORCEMENT n 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 ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
Sciv1\1111%
PLUMBING PERMIT APPLICATION
oil0:4e City of Spokane Valley Community Development Department
BuildingDivision
galley 11707 E. Sprague Avenue, Suite 106
dopO
Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509)688-0037
FOR INSPECTIONS, CALL(509)688-0054
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST is AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $6.00 =
3 TUBS X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL ON-SrrE BUILT X $6.00 -=
5 SINKS LAVS/BASINS,BAR,FLOOR,
KITCHEN,LAUNDRY,UTILITY, I X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CULINARY/MEAT
6 DISHWASHER I X $6.00 =
7 CLOTHES WASHER X $6.00 =
8 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, 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 =
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 ❑ MASTERCARD PROCESSING FEE $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
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R°F ,ait=r-FLANKING- PERMIT SITE PLAN
COMMENTS CITY OF SPOKANE BUILDING SERVICES
REVIEWED BY
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OWNER:
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JOB ADDRESS: 17 CL-A
H & H ENTERPRISES
W. 1019 FOURTEENTH
SPOKANE, WA 99204
747-4563
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Attic Ventilation
k\O / (,�,� 1 Sq Ft per every 300 Sq Ft of space
a ventilated with at least 5096 in the upper
y ` portion of roof area.
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rnsc,# , ; Y o�v e. ,Lr��u Y?�430
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/K"/" Under Floor Ventilat on
t Sq Ft per every 150 Sq Ft of under
— i3,,,e,t x, floor space area.-1 ventilating opening shall
be within 3 feet of each corner.Openings
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" G i7 r–•�- I shall be covered with approved material.
H &.H Enterprises
Q� Total Remodeling & Home Repair Service, inc.
747-45634-2532
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WHEN INTERIOR ALTERATIONS.REPAIRS OR " TIONS
REQUIRING A PERMIT OCCUR,OR WHEN ONE OR MORE
SLEEPING ROOMS ARE ADDED OR CREATED IN EXISTING
DWELLINGS.THE DWELLING UNIT SHALL BE PROVIDED
• WITH SMOKE ALARMS LOCATED AS REQUIRED FOR NEW
DWELLINGS.