2005, 05-26 Permit App: 05001804 Residence Project Number: 05001804 Inv: 1 Application Date: 05/26/2005 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: SCHMITZ,CLIFFORD&MARGO
NATURAL GAS Address: 16520 E SECRETARIAT LN
C-S-Z: SPOKANE VALLEY,WA 99037
Setbacks:Front 25 Left: 8 Right: 7 Rear: 40 Phone: (509)999-7733
Group Name:
Site Information: Project Name:
Plat Key: Name: SHELLEY LAKE 04TH ADD PUD District: East
Parcel Number: 45243.3301 Block: 5 Lot: 1
SiteAddress: 16212 E 9TH LN Owner:Name: SCHMITZ,CLIFFORD&MARGO
Address: 16520 E SECRETARIAT LN
Location::CSV SPOKANE VALLEY,WA 99037
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: 8,292 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review Released By: 0,tvitutvi;
,c,ic1
IPlan Review Released By: cj - ryzd +h.I u.it,it .`1
Sewer Review Released By: 1
Permits: ,
Operator: K_C Printed By: K_C Print Date: 05/26/2005
Project Number: 05001804 Inv: 1 Application Date: 05/26/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
Building Characteristics
Group: R-3 Type: VB
Total Area 2842
Building Height 24
Stories 2
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VB 1,421 $21,315.00 1,421 $21,315.00
COV DECK R-3 VB 104 $1,560.00 104 $1,560.00
GARAGE U-1 VB 690 $13,110.00 690 $13,110.00
RESIDENCE R-3 VB 1,421 $106,120.28 1,421 $106,120.28
Totals: 3,636 $142,105.28 3,636 $142,105.28
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,234.55
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $493.82
Permit Total Fees: $1,732.87
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509)325-4505
SPOKANE,WA 99202
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 3 #OF UNITS $3.00
VENTILATING FANS 4 NUMBER OF $40.00
CLOTHES DRYER 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: $95.00
Operator: K_C Printed By: K_C Print Date: 05/26/2005
Project Number: 05001804 Inv: 1 Application Date: 05/26/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: JIMMY'S PLUMBING Firm: JIMMY'S PLUMBING
Address: 1702 S MAMER Phone: (509)928-8991
SPOKANE,WA 99216
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
FLOOR DRAINS 1 NUMBER OF $6.00
WATER USING DEVICES 3 NUMBER OF $18.00
Permit Total Fees: $108.00
Notes
Payment Summary
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,732.87 $1,732.87 $0.00 $1,732.87
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $108.00 $108.00 $0.00 $108.00
$1,935.87 $1,935.87 $0.00 $1,935.87
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: 05/26/2005
BUILDING PERMIT APPLICATION WORKSHEET
S('i' Cit of Spoka alley Community Development Department
t Wi 9Building Division
11707 E. Sprague Avenue, Suite 106
.00Valle '� r: ; Spokane Valley, WA 99206
0 �e: (509) 688-0036; Fax: (509) 688-0037
UOLOON 4_
REQUIRED SITE INFORMATION
Street Address: /( Z I Z e . q
Assessor's Tax Parcel Number(s):
Legal Description: Lo 1 ..62, 1< 5171.6* 4 ke (-P-z/9-,0/9
PERMIT DESCRIPTION: )7_0,2. 1 lo-e'I Ci
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: ❑ Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
Contractor: el) Ft= SC_1rh4'( IV. >J5f ❑ Architect:
Phone: 641=7733 Fax: n /-997/ Phone: Fax:
Address: l(05'2_0 F , 5-6,6461-A./- 1-- Address:
t Zito the <-04 990-57
City State Zip Code City State Zip Code
WA State Contractor License #: J ,eSL/OV/-F Contact: £LI �C gqi 7-7 33
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:� ( DIMENS�,O��Z #OF STORIES:
MAIN FLOOR SQ. FTG: 2"" FLOOR �� UNFIN BASEMENT
E ki ANT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAG SQ. FTG: DECK/COV. PATIO SQ. FTG:
-,e .- 0 90 Io -(
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT S(OU :
#OF BEDROOMS: TOTAL HABIABLESPACE: IMPERVIOUS SURFACE AREA:
3
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR SEPTIC
L -� SYSTEM? -
[ ,
MANUFACTURED HOME •
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
I 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 1
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 ord. ances.
Ownership of resulting�� e lopmen rights granted by any issued permit.nur: o • •rop:,u ..wn;J.
Print Name Ci''` S ()--" Signature , y/t�-
Method of Payment: (Faxed permit applications will only be acc-pt/with ma . .ankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
•
MECHANICAL PERMIT APPLICATION Community Development Department
Building Division
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 Contact):
Mailing Address: City State Zip Code
Contractor: S-1-1-,L12-1)A W-41-1 t tit G License#: Phone#:
Mailing Address: city slab. , me cone
DESCRIPTION OF WORKS OF UNITS , X COST t = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal b or reds than 100.000 _ ( X $12.00 =
2 FUEL BU RNIIt G APPLIANCE Nae than 100.000 X $15.00 =
3 ^UNLISTED APPLIANCE(Add6onal Fee) Equal bot 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/REFRIGE3ATION 1.001-1.750M BTU X $35-00 _ '
11 BOILERIREFRIGERATION More than 1,750M B1U • X $6000 , =
12 GAS LOG.GAS INSERT.GAS FIREPLACE I X $10.00 =
13 RANGE `` X $10.00 , =
14 DRYER I X _ $10.00 =
15 FUEL BURNING WATER HEATER 1 X $10.00 =
16 MISC.FUEL BURNING APPLIANCE 3 X . $10.00 =
Ir
17 GAS PPG(each outlet) X $1.00 =
18 DUCT SYSTEMS X , $10.00 =
19 VENTILATING FANS LI X , $10.00 =
20 AIR HANDLER(DOES NOT indhde ducting) Equal lo or less than 10.000 CFM , X $12.00 =
21 AIR HANDLER(DOES NOT include ducting) &eater than 10,000 CFM X $15.00 = ,
22 EVAPORATIVE COOLERS . X $10.00 =
23 TYPE I HOOD X $50.00 =
24 TYPE I HOOD I X $10.00 =
25 HEAT.PUMP/AIR CONDITIONER 19.3 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&ADDITIONS • X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUSTX $12.00 =
38 INCINERATOR- X $19.00 =
37 INCINERATOR-COMMERCIAL X x„00 =
METHOD OF PAYMENT: SUBTOTAL
0 CASH 0 CHECK 0 VISA 0 NC DATE PROCESSING FEE $35.00
CARD I: EXPIRES: TOTAL PERMIT FEE DUE:
Al ITLJAr717Cr1 CI!_NATI IPG•
Alt* PLUMBING PERMIT APPLICATION Community Development Department
,,.,, Building Division
Phone: (509) 688-0036; FAX:(509)688-0037 11707 E. Sprague Avenue, Suite 106
• ny For Inspections,Call(509)688-0054 Spokane Valley, WA 99206
Project Address: Permit Use:
Owner. Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: S1 l/t Y 5 PLL.In GI►1J 6 License#: Phone*:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORKI OF ITS X COST = TOTAL AMQUNT
r
UN
1 TOILETS WATER CLOSET.BIDETS 3 X $6.00 = ►
•
2 URINALS X $6.00 =
3 TUBS Z X , $6.00 =
4 SHOWERS(PER TRAP) BATH.STALL,ONSITE BUILT I X $6.00 =
LAYS/BASINS.BAR,FLOOR,KITCHEN.
5 SINKS LAUNDRY.UTILITY,JANITOR.PHOTO. c X $6.00 =
X-RAY,FOOD, MEAT
6 DISHWASHER I , X , $6.00 = ,
7 CLOTHES WASHER I X $6.00 =
8 GARBAGE DISPOSAL i l X $6.00 = --
9 WATER SOFTENER X $6.00 , =
10 ELECTRIC HOT WATER TANK NOTE: F GAS,SEE MECHANICAL X $6.00 =
11 FLOOR DRAINS AREA,CASE COIL,TRENCH,CONDENSATE I X $6.00 =
ROOF DRAINSIOVERFLOW
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 3 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 D ISPOSAIISYS . , X $20.00 ,=
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
_
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions,curb lines,struc ures and easements
O /it, have been identified. s• in, ca -'• - - wetlands,
bodies of w -r -to • •pe- or.1�= ' ' areas.
Annnis i� �� , _
Signed:_
RUni,'Mu1H - josDate:
r Ni)N( f
CMIMENIS WWI .r+ _...
REVIEWS- - I
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