2011, 01-05 Permit App: 11000005 Plumbing FixturesProject Number: 11000005 Inv: 1 Application
TIJIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/5/2011 Page 1 of 2
Project Information:
Permit Use: REPLACE TUB W/SHOWER MOVE
WASHER/DRYER UPSTAIRS, 1 TLT,1 SHW, 1CW
Contact: HOLLANDSWORTH, J
Address: 10914 E 7TH AVE
C - S - Z: SPOKANE VALLEY, WA 99206-5548
Setbacks: Front Left: Right: Rear: Phone: (509) 924-5732
Group Name:
Site Information: Project Name:
Plat Key: 001827 Name: OLD ORCHARD SUB District: Sout
Parcel Number: 45212.1339 Block: Lot:
SiteAddress: 10914 E 7TH AVE
Location:: CSV
Owner: Name: HOLLANDS W ORTH, J
Address: 10914 E 7TH AVE
SPOKANE VALLEY, WA 99206-554
Zoning: R-3 SF Res District
Water District: 011 MODERN Hold: ❑
Area: 11,654 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review
Released lBy:
Originally Released: 1/5/2011 By: tmelbourn
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
This Application: Total Project:
Description Grn Type Notes So Ft Valuation So Ft Valuation
1&2 FAMILY R-3 VB PLAN 0 $1,000.00 0 $1,000.00
REVIEW
FEE
Item Description
RESIDENTIAL PERMIT FEE
WSBCC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Totals: 0 $1,000.00 0 $1,000.00
Units Unit Desc Fee Amount
1 SELECT $69.25
1 SELECT $4.50
1 SELECT $27.70
Permit Total Fees: $101.45
Operator: jmm Printed By: jmm Print Date: 1/5/2011
Project Number: 11000005 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 1/5/2011 Page 2 of 2
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 1 NUMBER OF $6.00
SHOWERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
Permit Total Fees: $18.00
Notes:
Payment Summary:
Permit Tvoe Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $101.45 $101.45 $27.70 $73.75
Plumbing Permit $18.00 $18.00 $0.00 $18.00
$119.45 $119.45 $27.70 $91.75
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: jmm Printed By: jmm Print Date: 1/5/2011
o.
CITY OF
\J O Community Development Department
-14-c rk Permit Center
1170$ East Sprague Avenue, Suite B-3
SpokAne Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@sookanevallev.orq
v,(OjOCt
(Staff Use Only)/�
PERMIT NUMBER: (I-00 CVO J�
PERMIT FEE:
TIAL CONSTRUCTION PERMIT APPLICATION
cp-
❑ NEVI CONSTRUCTION El ADDITION/REMODEL ❑ ACCESSORY BUILDING
❑ DECK r� i� OTHER j�� �% (� /
SITE ADDRESS: IOq 14 E- . l �� poiCaf\ CLQ i'�P i L k -1 ��E>
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:"
BUILDING OWNER NAME: 3QCIi1,C� fib (tox\VSLOOr fK
NAME:
S ai e -*Ufa li ds c3or _
ADDRESS: 'c )q 6 `,-
CITY: \ �! ' /
pOJC. 4'le nV & (1. i- STATE:
PHONE: I�t�{ 4- 5 `� '
,1-011
PHONE: daO— a'7 FAX:
CONTRACTOR NAME: ("1a`n1\1t- I^Q `C?
CONTACT NAME:
YVN
ZIP:
FAX: CELL:
MAILING ADDRESS:
CELL'
rsital Ross \
3SC5 - B0(o5J
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
DESCRIBE THE SCOPE OF WORK 1141 DETAfL AN,p NDI ATE USE & pROPOSED US
\(xce_, \ -I-u IA)l 0 ) Moo (ulr(€ f Waster
�- ZJ UtQ , rc()Vo e, +(16
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak:;
Dimensions: ' �I /j jd
No. of Stories: io A
Total Habitabil
Space: it
Main Floor SQ FT:
���
Upper Floor SQ /A
TVA,
Unfinishe I3 a ent SQ
FT: ��/�
Finished B ent SQ
FT: ,
Garage SQ FT:
�/�
Deck/Covered Patio SQ
FT: �, / /�
Impervious Surface
Area: �, w A
30% Slopes on
Property: //k
No. of Bedrooms: Ay%
Construction Type: WOO(
Heat Souro�
Sewed} or Septic:
TOTAL COST OF PROJECT: $
1,0001(.7°% o(L
pjSCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The 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.
Effective October 28, 2007 Page 1 of 2
P:\Community Development\02 Administration\03 Forms - Official Versions\Permit Center\Residential Construction Permit
App 10.28.07.doc
Signature
Date: t —2 —//
Method of payment: ❑ Cash ❑ Check
Bankcard #:
❑ Visa ❑ Mastercard
EXP: VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
P:\Community Development \02 Administration \03 Forms - Official Versions \Permit Center\Residential Construction Permit
App 10.28.07.doc
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)6890036 FAX: (509)688-0037
pamltcertcn s okanevallev OLE
Community Development
Plumbing Permit Applicationr
SITE ADDRESS: 10917' C.
PERMIT NUMBER:
PERMIT FEE:
0 Commercial �] Residential
s» X ne Ualleff to A- 99a
Building Owner
Name: d'arne.s 3t 4lrza s Leor¢t‘..... Pion: 9a4 -5-23a Fax:
Address: {b4 iL1- E .-7454. City: S(poLt 4c tJtLI r j state: 141- zip: ?e34
Contractor rami r
✓ojeaP
Name: / Phone: Fax:
Address: City: State: Zip:
Louise No: City Business Lic:
Contact/Project Managper. ],1
O f rnii Ross
Name: j'0 it ROSS
/ or
PI re: 990-5 s/
11385-3065
fp1T
# OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
r
rtia&c,/_ 7
URINALS
TUBS
race, -4- A.o
SHOWERS (per trap)
I, — Lblitt. a
SINKS
Lay/Basins, Bar, neer, Kdcben, laundry, Utillty, Jankor, Photo, X-ray, Food.
Prep/MN:are Meat
DISHWASHER
CLOTHES WASHER
���/�'^��'`�^
moue
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN
Area, Case, Coll, Trench. Condensate
ROOF DRAINIOVERFLOW DRAINS
FOUNTAIN, DRINKING
WATER PIPING/DRAIN-IN WASTE
Installation, Meratlons, Repair, Reversals
WATER USING DEVICE
Ice and/ Corms maker, Mae bib, steamer proefer, cerbonator, swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER
IfGas, See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS
Including traps, vams except kitchen type grease Interceptors functioning as Pleuro traps
REPAIR OR ALTERATION
Water piping, drainage o vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE
Other than ahnosohedc type vacuum breakers
MEDICAL GAS
INCEPTORS
DCASH ❑ CHECK ❑ VISA 0 MC
Card#
SIGNATURE:
EXPIRES:
VIN:
P:Commurity Development02 AdmineMlion1/3 Fonds- Official Versions\Perrnit Centet\Plumbmg Permit Application 00-03-09 dg.doe
cart
wer
Spokane
jUalley
For City Use Only
PLUS Project Number ,� (9.5
Project Address /v / t l 5 /2;1-1,.
11703 E Sprague Ave Suite B-3 • Spokane Valley WA 99206
509.688.0036 • Fax: 509.688.0037 • permitcenter®spokanevalley.org
As part of our on-going commitment to customer service during the review process of your project
application, we are providing you with a TARGET DATE for the initial technical application review. If for
any reason we cannot meet this date, we will contact you with a revised target date.
Your application review TARGET DATE is
0,1)0
The TARGET DATE is the date we estimate your project application will have had its initial technical
review. It is not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
➢ Submit complete, accurate plans and documents.
Extra time may be required for re -submittals as project application reviewers work on multiple applications and it
may be several days before they can look at your new or revised information.
➢ Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the
expertise for dealing with reviewer comments would be the best choice for the entire review process.
➢ Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date, please feel free to contact us if you haven't heard from us
by your target date. Staff may contact you before the target date if the initial review is complete. By following this
procedure, you will save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required
documents, as indicated on your Pre -Application Checklist have been submitted or have been approved for deferred
submittal. This does not prevent technical staff from requesting additional information as a result of their technical review.
2. Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free
from substantive flaws that would prevent technical staff from completing the technical review once it is started. When
this step is complete, your application will be routed to the appropriate staff and remain in their review queue until it
comes up for review.
3. Technical Compliance. Once an application is administratively complete, it is routed to technical staff for compliance
review. Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by
phone, fax, email, or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re -
submittals, each reviewer will approve their section of the application and route it to the Permit Center. When all sections
of the application are received, a Permit Specialist will process the application and contact the person specified on your
application for permit pick-up. Information regarding fees and pre -construction meetings (if required) will be provided by
the Permit Specialist at that time.
WHITE -APPLICANT PINK - BUILDING FILE
REV 9/07