2005, 03-17 Permit App: 05000809 Residence Project Number: 05000809 Inv: 1 Application Date: 03/17/2005 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: COURCHAINE,RANDY G
ELECTRIC Address: 19029 E BOONE#40
C-S-Z: SPOKANE VALLEY,WA 99016
Setbacks:Front 24 Left: 21 Right: 5 Rear: 20 Phone: (509)922-8147
Group Name:
Project Name:
Site In formation
Plat Key: Name: WOODLAWN PARK District: Sout
Parcel Number: 35244.0124 Block: Lot:
SiteAddress: 7307 E 9TH AVE Owner:Name: COURCHAINE,RANDY G
Address: 19029 E BOONE#40
Location::CSV SPOKANE VALLEY,WA 99016
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 7,000 Sq Ft Width: 70 Depth: 100 Right Of Way(ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: �..,,,,, ,,- dmrd. - _ 4,0&..,,,,-- t,.. - .a,m, :: : . ,s, .....
Review
Site Plan ReviewReleasedBy:
Originally Released: 03/17/2005 By: ddompier
Plan Review Released By:
Originally Released: 03/16/2005 By: TMELBOU
Approach/Drainage Released By:
SEE ATTACHED PROVISIONS
Originally Released: 03/17/2005 By: ddompier
4._____. Sewer Review Released By- Ai "'+ e l
Operator: DMD Printed By: DMD Print Date: 03/17/2005
Project Number: 05000809 Inv: 1 Application Date: 03/17/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Approach
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
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: OWNER Firm: OWNER
Phone: (000)000-0000
Building Characteristics
Group: R-3 Type: VB
Group: U-1 Type: VB
Total Area 1924
Building Height 15
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
GARAGE U-1 VB 624 $11,856.00 624 $11,856.00
RESIDENCE R-3 VB 1,300 $97,084.00 1,300 $97,084.00
Totals: 1,924 $108,940.00 1,924 $108,940.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,044.15
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $417.66
Permit Total Fees: $1,466.31
Mechanical Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
VENTILATING FANS 2 NUMBER OF $20.00
CLOTHES DRYER 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $40.00
Operator: DMD Printed By: DMD Print Date: 03/17/2005
Project Number: 05000809 Inv: I Application Date: 03/17/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 2 NUMBER OF $12.00
SINKS 3 NUMBER OF $18.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
ELECTRIC HOT WATER TANK 1 NUMBER OF $6.00
WATER USING DEVICES 2 NUMBER OF $12.00
Permit Total Fees: $72.00
NOtes >"AA..,_. n!illir x_ WNW.. . R,ev m_ fi._. 7`u,a t.% :" , =" ,ve1M_. ;IWr" A LAW
CONTOL AREA FOR DRAINAGE MORITORIUM SEE MAPS FOR SPECIFICS
Payment Summary•
Peuiut Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,466.31 $1,466.31 $0.00 $1,466.31
Mechanical Permit $40.00 $40.00 $0.00 $40.00
Plumbing Permit $72.00 $72.00 $0.00 $72.00
$1,628.31 $1,628.31 $0.00 $1,628.31
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: DMD Printed By: DMD Print Date: 03/17/2005
BUILDING PERMIT APPLICATION WORKSHEET
Siàne
1/1\111611t f p•► = e Valley Community Development Department
E C E L [ Building Division
11707 E. Sprague Avenue, Suite 106
4000
MQ 0 205 Spokane Valley, WA 99206
Valli
('%Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: -730 --) .-- 9 7 '‘ AO--(D 12 5--''—k'Ci
Assessor's Tax Parcel Number(s): 35 a i y • 0 /.2y
Legal Description: ,k?/6ae /,,siv ,, R rah' 1- I S / P/6 8/k, Fel N 7af
PERMIT DESCRIPTION:
pBuilding Permit ElChange in Use ElGrading ❑ Manufactured Home
n Relocation ❑ Tenant Improvement n Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
141 Owner: R ew0,4 G aUleGh 5..,.., Z Applicant: ytv,Dy dfQ c4,,'
4„ Phone: 9 (Y/ U 7 Fax: Phone: S�2 6/y7 Fax:
Address: t i 029 E Rba is #510 Address:
5 Vic,.,•e_ Cal/e y w j9 990 / ( 5 6��w /yy kill %' SGI.‘
o� State Zip Code Ci Sttte Zip Code
El Contractor: ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: < DIMENSIONS: #OF STORIES:
15 �(.. X 74 /
MAIN FLOOR TO SQ. FT9: . 2N" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: 6 y / DECK/COV.FPATIO SQ. FTG:
OCCUPANCY GROUP: 3 CONSTRUCTION TYPE: HEAT SOURCE: (_p(2..R
_ _
#OF BEDROOMS: 3 TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
CO OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
OF
D.060 /tic .- SYSTEM? Scw ei
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 E 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 inur to the property owner.
Print Name kaP/13 v� lT �� �� Signature 4
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
PLUMBING PERMIT APPLICATION Community Development Department
niIp Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
40/Valley
For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: 4)(.1
/ Permit Use:
• Owner: (�ftWDY 6 p Gh4 , i-,e Phone (Daytime Contact):
Mailing Address: 19 OD c/ E IoaA'C t'y0 S¢OdC16^-e- Ilfl/Py I-414 .f)G/
City 'State Zip Code
Contractor: • License#: Phone#:
•
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK *OF UNITS X COST , = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS' X $6.00 =
2 URINALSX $6.00 =
3 TUBS 7- X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ONSITE BUILT • X $6.00 =
• LAVS/BASINS,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 j X $6.00 , _
8 GARBAGE DISPOSALX $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 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 0 CHECK 0 VISA 0 MASTERCARD .$35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER: .
AUTHORIZED SIGNATURE:
•
MECHANICAL PERMIT APPLICATION Community Development Department
wane Building Division
diValklY Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: •
Permit Use:
Owner: Phone (Daytime Confact):
Mailing Address:
City State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City - State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
_1 FUEL BURNING APPLIANCE Equal to or less than 100,000 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 I X $10.00 =
14 DRYER i X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 = •
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS 3X $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 HOODx $10.00 _
25 HEAT PUMP/AIR CONDfTIONER 0-3 TON X $12.00 `-
= _
26 .AIR CONDITIONER 3-15 TON X $20.00 • .=
27 AIR CONDITIONER15-30 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
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: -
\\HI _s
f
AE
DDRESS - C '�
ZONE (l I�'-� r
ROAD WI
FRONT w� p� �� *i, so
COMMENTS��
Ar# gyri
.
a 4
.. .- Vit.
c _
F � t
4.4
r eq
t.
5 :iiik
r4_
0
t" P� iLi4l& 4:
f Q'
This site plan is being submitted for the purpose of- ,
obtaining a building permit and Is a true and correct' i
representation of the proposal. All known property
Ilines/dimensions,curb lines,structures and easements
- have been identified. Also indicated are wetlands,
1111 I
}
Ca 3
�,�,►
bodies of water, steep slopes or other critical areas.
F
Sinned: xp"-A._--- C•---
Date: a. //It, �.✓�e3�