2005, 11-04 Permit App: 05004100 Residence Project Number: 05004100 Inv: 1 Application Date: 11/04/2005 Page 1 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW RESIDENCE W/ATTACHED GARAGE-GAS Contact: VIKING CONSTRUCTION INC
Address: 2605 W HAYDEN
C-S-Z: HAYDEN LAKE,ID 83835
Setbacks: Front 36 Left: 56 Right: 15 Rear: Phone: (208)762-9106
Group Name:
Site Information: Project Name:
gaWanrewd.W,',-.._4 .. 71 : : "-,.x..:«,:.^; ..: - o -:.`-_€- .-=_"'
Plat Key: Name: RANGE District: East
Parcel Number: 55202.2101 Block: 5 Lot: 1
SiteAddress: 19208 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: 12,050 Sq Ft Width: 125 Depth: 96 Right Of Way(ft): 38
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review In formation _... ._ w=.� ._ rte_
Review
Site Plan Review
Released'By:
Plan Review Released By:
Originally Released: 11/04/2005 By: TMELBOU
Approach/Drainage Released By:
Originally Released: 11/04/2005 By: CJJANSSE
Sewer Review Released By:
Permits: �. . . .
Operator: CJJ Printed By: CJJ Print Date: 11/04/2005
Project Number: 05004100 Inv: 1 Application Date: 11/04/2005 Page 2 of 4
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
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
2ND FLOOR R-3 VB 482 $35,995.76 482 $35,995.76
BASEMENT F R-3 VB 20 $400.00 20 $400.00
BASEMENT U R-3 VB 966 $14,490.00 966 $14,490.00
DECK R-3 VB 140 $2,100.00 140 $2,100.00
GARAGE U-1 VB 493 $9,367.00 493 $9,367.00
RESIDENCE R-3 VB 1,000 $74,680.00 1,000 $74,680.00
Totals: 3,101 $137,032.76 3,101 $137,032.76
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,206.55
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $482.62
Permit Total Fees: $1,693.67
Operator: CJJ Printed By: CJJ Print Date: 11/04/2005
Project Number: 05004100 Inv: 1 Application Date: 11/04/2005 Page 3 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Mechanical Permit
Contractor: AIR DESIGN INC Firm: AIR DESIGN INC
Address: 1807 E FRANCIS AVE Phone: (509)487-4328
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 5 #OF UNITS $5.00
HEAT PUMP OR A/C 0-3 TONS 1 NUMBER OF $12.00
VENTILATING FANS 4 NUMBER OF $40.00
CLOTHES DRYER 1 NUMBER OF $10.00
RANGE 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $109.00
Plumbing Permit
Contractor: BELKNAP PLUMBING Firm: BELKNAP PLUMBING
Address: 3414 S ADAMS RD Phone: (509)921-5913
VERADALE,WA 99037
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 3 NUMBER OF $18.00
SINKS 5 NUMBER OF $30.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Permit Total Fees: $102.00
Operator: CJJ Printed By: CJJ Print Date: 11/04/2005
Project Number: 05004100 Inv: 1 Application Date: 11/04/2005 Page 4 of 4
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary'
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,693.67 $1,693.67 $0.00 $1,693.67
Mechanical Permit $109.00 $109.00 $0.00 $109.00
Plumbing Permit $102.00 $102.00 $0.00 $102.00
$1,954.67 $1,954.67 $0.00 $1,954.67
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: CJJ Printed By: CJJ Print Date: 11/04/2005
Permit Center 0 /, \\
ctn cx `-'
S o ;arse 11707 E Sprague Ave, Suit 0 I\i \ERMIT NUMBER9I On
Sookane Va11eV,WA 9920 � �
` a e�% � \\�\' P4ERMiIT FEE: _ I
�" ✓ k.Jv7wo0-vvJV L`Als. �JV7)O - 7 \ ) A " '
C' ti\
Community Development wa'ww.spokanevallev,orc.com O� \ \�_,
Residential Construction
Tew Construction ❑ Accessory Bldg
Permit Application o Addition/Remodel ❑ Deck
o Other:
SITE ADDRESS \C t —1-4\ 13,0.Pe i n I,
ASSESSORS PARCEL NO: J)ca )10 I LEGAL DESCRIPTION: .. k relook, CV�'-l4 cfc ut(
i
Building owner Contractor
Name: \ k q N'111\j li)1 Name: NU,
Address:1.AIC5 'u . _ Lt_.:y\ \-ue_-- Address:
City:`,\ca'n Zip: t.� 3 5 City: Zip:
n
Phone: " U)) -6(161,9 Fax: ILp,)—u6b Phone: Fax:
Lic No:Ni 1I&I tV(i t.Q10.4:3 Exp.Date:
Contact Person •City Business Lic No:
Name:
Phone:
Describe the scope of work in detail: Cost of Project: $
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO, QTAK: if DIMENSIONS: Qj #OF STORIES: TOTA A ITA E SPACE:
MAIN FLOOR TO SQ. 2ND FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG: AREA:
l OOO a(t'- L(S c'r� o� J' , Ga .C� . a.. Q(
FINISHED
FTG: BASEMENT GARAGE SQ. FTG• DECK/COV. PATIO SQ. FTG: 30% SLOPES ON
SQ.
LA� of
) b PROPERTY: 1.._)/11-
#OF BEDROOMS: CONSTRUCTION TYPE: HEAT SOURCE: SEWER OR SEPTIC?
3 L ..-"S; Cis w x.02
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. 6) Plans or additional information may be required to be submitted,and subsequently approved before
this application can be processed.
SignatureD ----)k&I .,,,u : V U` �i it Jli Date � � ��1I
Method of Payment: (Faxed permit appli a ions will only be accepted with major benkcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard#: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
,
,,,�� Permit Center
f"kan- e 11707E Sprague Ave,Suite 106 D jj• jar m>�jEIZ.
.000 Valley Spokane Valley,WA 99206 -,:�`.
(509)688-0036 FAX:(509)688-0037 p)1i�vitTFEE
Community Development www.spokanevallev.oro.com
Plumbing Permit Application o Commercial x Residential
SITE ADDRESS ,•_ `
\
Building owner Ni t `
Name: `Y 13Y-:t �i iK_� �1'u t-� �C
tty,) Phone: Y ----An, -�U Fax 1')-- 104--Lice-\--1
Address: ')S ILO. l-i ( \( )(1 \\)e City OA t 1 State L ) Zip b?);-)6
Contractor 1' r - ,
Name: ' 1 Vii-,fl�b{q Phone;f. --CO-t — fj"i t Fax:
Address: 4-�1 -S City \[ % State Zip 4C1L-j1
License No: P1 i.,�� 6
ul'MU City Business License No:
Contact
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 0 X _ $6.00 =
2 URINALS ^ X , $6.00 =
3 TUBS pl X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT i X $6.00 =
LAVSBASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER I _ X $6.00 = _,
7 CLOTHES WASHER % X $6.00 =
8 GARBAGE DISPOSAL 1 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 h 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 DISPOSAUSYS X $20.00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
❑ CASH ❑ CHECK ❑ VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05
Permit Center
S`"okan'e�� 11707 E Sprague Ave,Suite 106 Ez tNT ER
j•Ualley Spokane Valley,WA 99206
(509)688-0036 FAX:(509)688-0037 "^"
Community Development www.srokanevallcv.ore.com P.ERMITFEE ;
Mechanical Permit Application o Commercial o Residential
SITE ADDRESS t 1-14) t U.-
Building owner (�
Name: X 1 Il I11T.; l Q0?-yS'\).ru llY1 ai\ Phone: .,).- • _olinG Fax Ai`P.-' _t5r
Address: r}&yD q7 . oil NiN 'e_ City State Zip 'Qt- Q5j 5
Contractor ,
Name: till! °sk('}n Phone: Fax:
Address: 1 City State Zip
License No: City Business License No:
Contact
Name: Phone:
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT_
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I 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/REFRIGERATION 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 1 X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER t 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 FANS4 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 OR PELLET STOVE/INSERT X $10.00 =
32 WOOD STOVE-FREE STANDING X $25.00
33 REPAIR&ADDITIONSX $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 $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: REVISED 8/26/05
. .
I Call 24 hou pec. on
Phone 509.681;-0036F 509.6i-38-0037
c...-trn.
alley
DEPARTMENT OF PUBLLC WORKS
Antctp. tcf start date Permei # PW
APP'ROACE1 PEREtT
APPLECATIOH
Location of property •Mr)-Cre) 14h Ne-
.1.••••31M.*•
,eiddress/Parcel #, favailable)
, ,v)
Applicant Hama ‘; i!
Phone rf
' • • k
Contractors Name ‘f Oa; LU-t-
Address ,nc . hone (-f)-OF,
Contractor's Rege S Expires -(7-311 1 li.:)(L)
PROJECT DESCRIPTION (Provide site sketch)
ResidentialDriveway Commercial/lIndustriai Drivelitray
Ej Existing Curb & Gutter I] Rural Road Section
ri Culvert installation ri Sidewalk Rapair/Construction
•
Pq Other conditions brki / "7r1)1
See construction requirements and details-on reverse. BorKiiibsuranoe certification must be on
file with the City.
SPECIAL C0fDTIO1 :
PERMIT FEE $ inspection Fee$_,,,
.....
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card 4-4 Expiration Date
Name of liolder Signature
Fees PaEd$ Date
•—
** TOTAL FREE.55 **
r
Spokane
CJ�,), DEPARTMENT OF COMMUNITY DEVELOPMENT
CURRENT PLANNING
40,00V11i� 1ADMINISTRATIVE EXCEPTION
�I APPLICATION AND DETERMINATION
CDTj2C1TLo4 PART I
APPLICANT: V ( I44 7
MAILING ADDRESS:EStV cy �Q� 17 A00..
t
CITY: Ip4qYLL)p/� STATE: )DA O ZIP: 83b JJ
PHONE: (HOME)2.S.75- -etkok, (woRK) (CELL)
NOTE: IF APPLICANTIS NOT THE OWNER,INCLUDEC � WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW
`
LEGAL OWNER: \\(.31/40C ._ U�V l '1 -,QI I c
MAILING DRESS: d U (;) \"I[.0 l XQ-\ IA` e_
CITY: 1 Afi STATE: L C� . ZIP: ' &;--3,5
PHONE:(HOME
:40?)- { � 'C1 I Cb (WORK) (CELL)
iml.!
TAX PARCEL No: 1-:) )..)b"..4 `)- STREET/ADDRESS-OFF SITTEEi:, •I '_1)—C) \ C 1
LEGAL DESCRIPTION:
�• �+ti� VA LC..a I, W sr-xS lrk►!•3 Fn TC)tJ
SECTIONS) TOWNSHIP RANGE
ZONING CLASSIFICATION: "12-3,e----
•' COMPREHENSTVE PLAN CATEGORY:— 7)0}.... 741).
TYPE OF ADMINISTRATIVE EXCEPTION REQUESTED: �.0 T LkC�E AG. A2. �A2I
5E-- 3`t 1 01
EXPLAIN REASON FOR REQUEST: r ( CIA L ST A t ••
S►l;I3C.a 07
`P&_—_ _ I (-(. lC). too oF' 2K5r-67;i21 1wk
Zc�IJt tJC� C-0D E C(7-`) Of- i:›43Ie-NAE
APPLICABLE SECTION(S)OF ZONING CODE:
NOTE: A SITE PLAN AND SUPPORTIVE DOCUMENTS SHALL BE LNCLUDED WITH THIS APPLICATION
s ,
PART II
LEGAL OWNER SIGNATURE
(Signature of legal owner or representative as authorized by legal owner)
I, )C UACIdi C15Lt} , (print name) SWEAR OR AFFIRM THAT THE
ABOVE RESPONSES ARE MADE TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE.
I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA PROPOSED
FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER, ATTACHED
HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY ACTIONS ON
HIS/HER BEHALF.
ADDRESS: a-UL VS W. 0 (u(Lf1 `P-- PHONE:: ,v "_1( - ix,
l-ifs.li 1 J--lb ZIP: f&-3(q)76
(City) , tate
_ _: '.1d7;, ' j *7-
(Signature) (Date)
NOTARY
1-4AC )G (For Part II above)
STATE OF WASIIINCTON ) ss:
COUNTY OF. - )
V'OG .Ll.,
•
SUBSCRIBED AND SWORN to before me this I day of 0 C XJ em�Pf , 20, VS
** .-.).1--57t'1/4-A---DV4i1/61A-3Z-,-- .
Q o T A R y * NOTARY SIGNATURE
*i • = Notary Public in and for the State of u
Residing at: V1GCi-6114' S
•
���umiiii������ My appointment expires: CI I --I CCO9I
PART III
(To be completed by the P1.a .r g Staff
II g /)DATE SUBMIT ED: 1 I (/� RECEIVED B f'''4.1.1I f e de-,
FEE: P Pc
FILE No.: 1' ` c�C
ID1A.3 i 05- ate
•
PART IV
DETERMINATION
File No: AET
The Department of Community Development finds that the information provided by the applicant and required
compliance with the City of Spokane Valley Zoning Code and all other development regulations, does/ does not
adverse affect on the adjacent properties nor the public's general health, safety and welfare.
The Department of Community Development approves/ denies this "Administrative Exemption" as conditioned
below, for the property described in Part I,pursuant to Sections 14.506.000 and 14.506.020 of the Zoning Code.
This administrative exception is subject to the following conditions of approval:
1) This administrative decision shall apply to the subject property indefinitely and may be transferred to future
property owners, heirs or any successor in interest to the property subject to the conditions of approval
contained herein.
2) The applicant and property owner shall comply with all requirements and regulations of the Zoning Code.
3) The applicant shall comply with all applicable development regulations and standards.
4) The applicant and property owner shall comply with the following additional conditions:
k �Qr
This administr•tiv Q exceptio s herb approv d this �J day of i`t�,el) .2005
too viLCA
Approved b( ' 04. ('i 1L Title:
Under Section 14.412.041 of the City Zoning Code,any person aggrieved by this administrative determination has
the right to appeal this administrative decision to the City of Spokane Valley Hearing Examiner. An appeal must
be filed by submitting the appropriate appeal application together with the required fee to the Department of
Community Development Current Planning,within fourteen(14)calendar days after the decision is issued. Upon
receipt of a complete appeal application,a public hearing will be scheduled.
For information or questions, please call(509) 921-1000 Rev 6/03