2003, 07-06 Permit App: BD03-745 Residence �
City of � �
�
SPOKANE VALLEY
PERMIT# 0 5
BUILDING PERMIT APPLICATION
Box 1 OWNER JOB LOCATION 1 1 60 Z e gri/
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB I2-e-S t DeAt
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME ��% to / Z tSs — PHONE `1//:-..?? ?
CONTRACTOR'S ADDRESS I£ c w £: 5 c mi.-;et 1- CITY Clea14-3 .
CONTRACTOR'S REG.# �F 5-C. I OV/Z A' EXPIRATION DATE 11.—>L/
(CARD MUST SE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT L 1. PHONE q 't 7 '233
ADDRESS -3_6-1►'t.e CITY ZIP
BOX 4 SEWER AVAILABILITY ye s WATER AVAILABILITY C.�.(J
BOX 5 ESTIMATED PROJECT COST$ {
EXISTING BLDG. VALUATION$
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
i.tINJUa NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR 1 I / 2ND FLOOR ' ' /
3RD FLOOR `b / OTHER 15-- / BASEMENT FINISHED /
BASEMENT UNFINISHED 520 / DECK eo / GARAGE 57.f) /
CARPORT / TOTAL / 53 / HEIGHT TO PEAK OF BUILDING t g FT.
BOX 8 (- SINGLE FAMILY (t..--1-NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE SQ. FT.
BOX 9 PLUMBING FIXTURES(Including rough-ins) MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
BOX 10 Water Service meter size(if known)
Also see BOX 4
BOX 11 Septic Tank—Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
BOX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND
CORRECT TO THE BEST OF M K"O 'L 2 GE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERF•' TH ••4 FOR WHICH THE APPLICATION IS MADE.
OWNER/AGENT ' l/''-
,�� � DATE /—�/ �3 (OVER)
Site Address: 11602E 8TH AVE Project Number:�JLJ D 1)O 3
7Liv: 1 Issue Date: -7/7/0 6,
SPOKANE,WA 00000 Permit Use: �
Parcel Number: 45214.9305 't 6(Gt�
Subdivision: jl — !L 8"0( Applicant: CL1FJ SCHMITZ CONSTRUCTION
Block: Lot: 16520 E.SECRETARIAT
Zoning: UR-3 Urban Residential 3.5 VERADALE,WA 99037 Phone: (509)922-4297
Contact: CLEbr SCHMITZ CONSTRUCTION
Owner: SCHMITZ,CL1hrORD&MARGO 16520 E.SECRETARIAT
Address: 16520 E SECRETARIAT LN VERADALE,WA 99037 Phone: (509)922-4297
VERADALE,WA 99037-
/ Setbacks-Front: Left: Right: Rear:
Building Inspector: K-Q 0)1 v) M9
i 7
Water Dist: "(
Group Name:
Project Name:
Permits
Sewer Connection Permit Contractor: CLIFF SCHMITZ CONSTRUCTION License#: CLIFFSC 104RF
APPROVALS
BUILDINGS: 4e10-7.1 '
PLANNING. , I
ENGINEERS: t)-f›- q1-19,
((k,`
HEALT : V
SEWER H 7/7
FIRED l. •
_-.--_
rD
1Y ojd o� 2
00 +o �.
y', � Q 0
90"
QQ -S---G i l
L. / 61
b I
oo - - -3 Q $
Q0 - -S L. - Q° h1 or
Ob. 29 Z?) o ff L -� �a 11
City of SPOKANE VALLEY BLD O.P. 23C
Building, Fire and Public Works Fees Receipt
Applicant/Business S ),' ,'-5 �`�-z S17uie rmit No BO 03- 71-45---'
Project Name Date "2/7703
Site Address Ii 620P.
Please Receipt the Following:
Check Number Receipt Number
Payer's Name si-2
Address __405S ec 7( ity \)-eCcJci.he Zip 9610-s
BUILDING DEPARTMENT
001.059.322.10.01 Building Permit $ q.'15-T, P73-
001.059.322.10.02 Plumbing Permit $ 7 -E'f>
001.059.322.10.03 Grading Permit $
001.059.322.10.04 Mechanical Permit $ -7 7 -
001.059.322.10.06 Demolition Permit $
001.059.322.90.01 Misc. Permits and Fees $
001.059.345.83.01 Plans Check Fee $ cy /_ 75-
001.059.345.83.03 Energy plans check fee $
001.059.342.40.02 SPECIAL Inspections $
001.059.237.10.98 Bonds / Deposits $
001.059.237.10.02 WSBCC Surcharge * $ LI..5D
FIRE DEPARTMENT #
001.059.322.10.07 Plans check fee $
001.059.322.10.08 Sprinkler plans check $
001.059.322.10.09 F. A. Plans check $
001.059.322.10.10 Misc. plans check $
001.059.322.10.11 Fire Alarm inspections $
001.059.322.10.12 Sprinkler inspections $
001.059.322.10.13 Misc. Inspections $
001.059.321.30.00 Fireworks Permit $
001.059.342.40.01 UFC permit fees $
001.059.237.10.99 Bonds / Deposit ** $
OTHER: $
PUBLIC WORKS
001.059.322.40.00 Right of Way $ €)
001.059.342.40.03 Special Inspections $
001.059.237.10.99 Bonds/Deposits (cash)** $
TOTAL AMOUNT DUE $ i 329 *OD Ai
/
* To be sent to Wash. State Building Code Council quarterly. V
-- # 65% of figure to be sent to the Fire Department Quarterly, except bonds etc.
** Liability Insurance verification may also be required.
s-vb1d23c 4-21-03
SaTY a`,,�,,�r� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
pore Spokane Valley,WA 99206 509-688-0037-Fax -
�VeY For Inspections, call 509-688-0054
'Mechanical Permit Application
PROJECTk PERMIT
ADDRESS: ' ( V USE:
OWNER PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR aLtte _( Jev ( ,� LICENSE S:
MAILING ADDRESS: 7 l �1%L PHONE S:
(street) (city/state) (ZIP)
DESCRIPTION OF WORK t OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE =OR<100,000 1 X $15 = /15-
2
,52 FUEL BURNING APPLIANCE >100,000 X $19 -
3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X S50 =
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 =
5 USED APPLIANCE(WSEC min AFUE rating) -or<400,000 X $50 =
6 USED APPLIANCE(WSEC min.AFUE rating) >414000 X $100 = -
7 BOILER/REFRIGERATION 1-100M BTU X $15 =
8 BOILER/REFRIGERATION 101-50081 BTU X $28 -
9 BOILER/REFRIGERATION 501-LOOOM BTU X $39 =
10 BOILER/REFRIGERATION 1001-1,750M BTU X . $57 =
11 BOILER/REFRIGERATION +1750M BTU X $95 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE - X $10
13 RANGE - X $10 =
14 DRYER - 1 X $10 = jp
15 FUEL BURNING WATER HEATER - t X $10 - /0
16 MISC.FUEL BURNING APDL - X $10 =
17 GAS PIPING(et Outlet) - 7 X S1 2
18 DUCT SYSTEMS - X $10
19 VENTILATING FANS - X $10 - -E .
20 AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM X $12 =
21 AIR HANDLER(DOES NOT indude ducting) >10,000 CFM X $19 =
22 EVAPORATIVE COOLERS - X $10 -
23 TYPE I HOOD - - X 350 -
24 TYPE II HOOD - t X $10 - %L)
25 HEAT PUMP/AIR CONDTITONER 0-3 TON X 312 -
26 AIR CONDITIONER 315 TON X $20 -
27 AIR CONDITIONER 15-30 TON X $25 -
28 AIR CONDITIONER 30-50 TON X $35 -
29 AIR CONDEMNER +50 TON X $60 -
30 LPG STORAGE TANK - _ X $10 =
31 WOOD OR PELLET STOVE/INSERT - X $10 -
32 WOOD STOVE-FREE STANDING - X $25 =
SUBTOTAL• 77.-CC,
t/IJ
METHOD OF PAYMENT PLUS PROCESSING FEE 5.08----d
Mini TOTAL PERMIT FEE DUE:
0 CASH 0 CHECK 0 iiiiiiiii 0 - -_.-
DATE: EXPIRES:
BANKCARD NUMBER
LijiuitaiieI Spokane Valley,WA 99206 509-688-0037-Fax
�1�/a..1ey For Inspections, call 509-688-0054
Plumbing Permit Application
PROJECT PERMIT.
ADDRESS: 111(J 0 Z. k g USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR I tls-M / S P /� et LICENSE I:
MAILING ADDRESS: APHONE I:
(street) (city/state) (ZIP) -
•
PLUMBING FIXTURES
DESCRIPTION DETAILS I OF UNITS X COST EQUALS AMOUNT
1 TOILETS WATER CLOSET,BIDETS `7 X $6 12
2 URINALS ' X $6 -
3 TUBS 1X $6 - LP
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6
5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN,
LAUNDRY,UTILITY,JANITOR,PHOTO,X-
RAY,FOOD,PREP/CULINARY/MEAT X l
6 DISHWASHER ) X $6
7 CLOTHES WASHER X $6 -
til
8 GARBAGE DISPOSAL X $6 -
- 9 WATER SOFTENER X $6
10 ELECT.HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X $6 -
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X S6 -
le
12 FOUNTAINS,DRINKING X $6
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR,
WASTE,VENT,PLUMBING REVERSALS X $6
REVERSAL
14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB,
STEAMER,PROOFER,CARBONATOR, X $6 -
SWAMP COOLER ` L
'% CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND
$6 -
R.P.B.P.D.FOR:VATS,TANKS,BOILERS X
17 SPRINKLER SYSTEM X $25
18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL
HOLDING TANK X
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6
20 MISC.PLUMBING FIXTURE X $6
SUBTOTAL: /,2THOD OF PAYMENT
i.
- PLUS PROCESSING FEE: --
CASH 0 CHECK 0 NM= 0
TOTAL PERMIT FEE DUE:
'E: EXPIRES:
1KCARD NUMBER:
HORIZED SIGNATURE:
11 (002--
1
5q
c7L
(Asukot
12-01
)0
23' -, zs' 'go'
35°
Pt-
APPROVED E3V---
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