2005, 05-11 Permit App: 05001554 Residence Project Number: 05001554 Inv: 1 Application Date: 05/11/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE- Contact: VIKING CONSTRUCTION INC
NATURAL GAS Address: 2605 W HAYDEN
C-S-Z: HAYDEN LAKE,ID 83835
Setbacks:Front 36 Left: 12 Right: 48 Rear: 37 Phone: (208)762-9106
Group Name:
Project Name: ROW
Site Information.
Plat Key: Name: RANGE District: East
Parcel Number: 55202.2103 Block: 5 Lot: 3
SiteAddress: 19116 E 7TH AVE Owner:Name: VIKING CONSTRUCTION INC
Address: 2605 W HAYDEN
Location::CSV HAYDEN LAKE,ID 83835
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 13,616 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 38
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Released By:k.
Plan Review Released By: ö(( ,e, d ii/E r L
Approach/Drainage .Released ByJy(6C_La("0-4d
Sewer Review Released By: 6s---
Permits:
Operator: K_C Printed By: K_C Print Date: 05/11/2005
Project Number: 05001554 Inv: 1 Application Date: 05/11/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Approach
Contractor: VIKING CONSTRUCTION Firm: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE Phone: (208)762-9106
HAYDEN,ID 83835
Item Description Units Unit Desc Fee Amount
APPROACH INSPECTION 1 NUMBER OF $25.00
CONST IN ROW-APPROACH 1 NUMBER OF $25.00
Permit Total Fees: $50.00
Building Permit
Contractor: VIKING CONSTRUCTION Firm: VIKING CONSTRUCTION
Address: 2605 W HAYDEN AVE Phone: (208)762-9106
HAYDEN,ID 83835
Building Characteristics
Group: R-3 Type: VB
Total Area 1565
Building Height 20
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Sq Ft Valuation
GARAGE U-1 VB 483 $9,177.00 483 $9,177.00
RESIDENCE R-3 VB 1,565 $116,874.20 1,565 $116,874.20
Totals: 2,048 $126,051.20 2,048 $126,051.20
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,144.95
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $457.98
Permit Total Fees: $1,607.43
Operator: K_C Printed By: K_C Print Date: 05/11/2005
Project Number: 05001554 Inv: 1 Application Date: 05/11/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Mechanical Permit
Contractor: FITTING MECHANICAL Firm: FITTING MECHANICAL
Address: 10223 HAPPY TRAIL Phone: (208)687-6949
RATHDRUM,ID 83858
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 5 #OF UNITS $5.00
AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00
VENTILATING FANS 3 NUMBER OF $30.00
CLOTHES DRYER 1 NUMBER OF $10.00
RANGE 1 NUMBER OF $10.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $117.00
Plumbing Permit
Contractor: BELKNAP PLUMBING Firm: BELKNAP PLUMBING
Address: 3414 S ADAMS RD Phone: (509)921-5913
VERADALE,WA 99037
Notes:
Payment Summary: ; . .
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,607.43 $1,607.43 $0.00 $1,607.43
Mechanical Permit $117.00 $117.00 $0.00 $117.00
$1,774.43 $1,774.43 $0.00 $1,774.43
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: 05/11/2005
CITY BUILDING PERMIT APPLICATION WORKSHEET
_ City of Spokane Valley Community Development Department
. -- P � f Building Division
11707 E. Sprague Avenue, Suite 106
Valle Spokane Valley, WA 99206
40,0phone: (509) 688-0036; Fax: (509) 688-0037
II REQUIRED SITE INFORMATION
Street Address: iq I) -1e
Assessor's Tax Parcel Number(s): 55 1-,,Q a 1 b 3 Si
Legal Description: Llu- -\L 5 ��9.f\ `� 'X L-Y�''� _ I
) �C ��� � `
PERMIT DESCRIPTION: :. i�ire_ Q61 A CC (
Building Permit ❑ Change in Use ❑ Grading El Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
11
OWNER/APPLICANT INFORMATION
R Owner: ekxy\c` (1_0( rli S1 Qr - Applicant: a_sy- "
Phone: "alba-Gt04, Fax: 'ltpa-u-A-V:501 Phone: Fax:
Address: • . _ __ :. I. - Address:
4V.,u)(23,0 ) `)-( )coCity
d, State Zip Cade
City State Zip Code
Contractor: c?- [ (�Al-Ihri (y i \r Fax•
Phone: Fax: .
Address: Address:
State Zip Code � City
c
State Zip Code
City
WA State Contractor License#: _k G • •. Iv- • c
Spokane Valley Bus. Liscense #: Contact:
lI PERMIT/BUILDING INFORMATION 1
N
HEIGHT 11 POEM K: DIMENSIONS: i #OF STORIES:
tO X 4(1 -fes
MAIN FLOOR TO SQ. FTG: 2"D FLOOR SQ. FTG:S WA I UNFIN BASEMENT SQ. FTG:
FINISHED A BASEMENT SCS, FTG: I GARAGE SQ. FTG: I DECK/COV. PATIO SQ. FIG:
G:
/A // ''tt''11 /
OC UPANCY GROUP: CONSTRUCTION TYPE: HEAT SOUR E:
jiIF. LIQ . C4l, 12,g51 VY-rrtAt, &A4
#OF BEDROOMS:„ TOTAL
rHABBIITABLE SPACE: IMPERVIOUS PRFACE AREA:
ffl
COST OF PROJECT: 30% SLOPES ON PROPERTY: I SEWER OR ON-SITE SEPTIC
IC
I 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 [ 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: (Fa);ev permit applications will only be accepted with major bankcaro)
❑ Cash ❑' 'Check ❑ Mastercard �?� -; ❑ VISA ,
❑.:C3thpr
y
Bankcard #: `'. ' ' �fres:.� ViN#: ' ' '.-
Authorized Signature ► s a •,
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
rim cine BuildingDivision
�l►Cl c� 11707 E. Sprague Avenue. Suite 106
1'a ev Spokane V2lley, WA oo°n�
___,,,j
� - tI Phone: (509) 688-0036;Fax: (509) 688-0037
FOR INSPECTIONS, CALL(509) 688-0054
'r -14-h � ermit Use:P
Project Address: '' ---:.:,-,' -','-
Owner:
."" ,'-
- - � CIL-
,
,.
.i.-C _. =, .L-
Owner: dei '1 i ;-',"\ -^': .- ;- tPhone (Daytime Contact): �: �: -'I E�
Mailing Address: , i 1.', u..1,`, 'i--t- ___11',... (�', )y'.f"' t-t- . ,_ -\� T I� ) ,';,--:
L - City, 'tY State Zip Code
�- / -„A r =,-,-:;)r �: Phone#: -fr; I =' ( ` �
Contractor: F' i� r j;"� , r 4 ke4 J`r` 4_ License#: �.
\
Mailing Address: r ,�i) t j"��,�,1 t H 1, .�t'.;:..;,. , ._ t '~ti
r- �; ,.' ) Zi Code
City State P
i/OFTOTAL
DESCRIPTION OF WORK UNITS , X =' COSTAMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 t 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 X $50.00 =
5 rating) Equal to or less than 400,000
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 BnILER.IREFRIGERATION 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 FIREPLACE t X $10.00 =
13 RANGE ' X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER
1 X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 5 X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS 3 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 1 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 0m
DATE: PROCESSING FEE I I $35.00
EXPIRES: TOTAL PERMIT FEE DUE:
CARD»:
AUTHORIZED SIGNATURE:
b PLUMBING IMBING PERMIT APPLICATION
SOY Ts pokane n
City of Spokane Valley Community Development Department
BuildingDivision
T 11707 E. Sprague Avenue, Suite 106
Spokane40,1t
agAve vert to 10
Phone: (509) 688-0036;Fax: (509) 688-0037
r FOR 1fi/SPECTIONS, CALL (309) 688-0054
Project Address: iL`1 \�LQ t� ]4'h N . Permit Use: .
Owner: t f : '' , . � , J, Phone (Daytime Contact):-���- .-
,. -
Mailing Address: P t,,; ',�, _,r '
• i
P n k� ar ti y r,�� � ` L� -rte L.-:
City F. State Zip Code
r +r _
Contractor: k� 4 Li'v
r " _)... w, License i k: t t,r �i� 4�`.r' hone#: „L ' -Qr
^
a ,c.:-.:-, s . r s ;
i'Vaiiing address: ;5--, �l' "� _ , z H''') + r',. . i- (-A L ' up --A_
City .. State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 TOILETS WATER CLOSET,BIDETS O/ X $6.00 =-
2 URINALS X $6.00 =
3 TUBS I X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT ') X $6.00 =
5 SINKS LAYS/BASINS,BAR,FLOOR,
KITCHEN,LAUNDRY,UTILITY, X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD, p
PREP/CULINARY/MEAT ✓�
6 DISHWASHER I X $6.00 =
7 CLOTHES WASHER I X $6.00 =
6 GARBAGE DISPOSAL I 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 BIB,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 ❑ CHECK ❑ VISA 0 MASTERCARD PROCESSING FEE $35.00
DATE: EXPIRES: I TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Cell 24 hours before inspection required f
Phone 509.688-0036 -0h 6 003
Phone Fax .> 7.VOQ-VU5 /
DEPARTMENT OF PUBLIC WORKS
ArTtrcfpateci stare data P r ft # PW
APPROACH PERF CT
Location of property iLi i
c CddressfParoef # )
cf avaliabf
,( II ra P sa gyp,. tom, G
Applicant {��U ar i l b
61
df r ' ` Z-i F h ` h f�( .4f ::J�Ri..t'• a ilC�rU6� ti ;-- `-t G i ,G
�c�trac '>�s E � � �" a kJ�. � ` ,:r ? 6 E ' :_; t
j
Address -, C�( `�, a'. ! .5,c,C _6� Phones
n r -�
Contractor's Reg# C. V-7\ � '._�, (24(t.C:_ t"4 J_, Expires ,/t �t s(r'
PROJECT DESERTPT1OW (Provide site sketch)
Residential Driveway Contrnerciaflfndustriaf Driveway
E fsthng Curb & Gutter Rural Rod Sectio
Culvert Installation Sideway: Repair/Construction
RI Other conditions
See construction requirements and details on reverse. Bond/insurance certification must be must
file with the City.
SPECIAL CCRDfTION3:
PERMIT FEE Irts��ction ee$
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card# Expiration Date
.
1 Name of Holder Signature.__...
Fees Pard$ Date
n,* TOTAL PAGE.O5 **
r
ITE �'L4N
l 20'-0"
� SCALE: 1
0400019$
. LOT 3 BLOCK 5
8
i.w ,) ,Lu,. . COUNTRY CROSSINGS
�A 4 SPOKANE VALLEY,WASHINGTON -I
YiE--.
112.27' W
Q W wi
VIA Oi
3!
ff of
vi
112'-0" 52'-0" / 48'-3 1/4"
�M � ,
I
CONC ri
PATIO t
G
L,.)
cn:
i
OM 4li
0 ii
J
CONC.
\ PORCH AND SIDEWALK U 1i
0
\ CONCRETE WATER
7C\i UNDER DRIVE
o `y\ GROUND
POWER Q
M ) ' SIDE�i ALK (C)�
82.22' ..
\ `)IURB
V
This site plan is being submitted for the purpose of
SEWEPobtaining a building permit and is a true and rt
representation of the proposal. All known property
Imes/dimensions,epretatsnof curb lines,structures
d and
areeaSements
wet aeds.
SEV�NTNAVE..------------------------hav1� lz� rrr��,�E>�lopes
bodies of water, steep
SightsI 6
/ or-
Date: z