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2003, 10-08 Permit App: BLD-03-02653 Residence CITY• sI; , le 1 �' a PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIVISION 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: / Z Z- I E L- A fiJ C> {i K � V�. / {' 7Y G ASSESSOR'S TAX PARCEL NUMBER(S): `d. t LEGAL DISCRIPTION: L d T L C{ fC 4-1JI e t 'e�/ L4 kQ L I d PERMIT DESCRIPTION: K e S 3 c o-- r- hit (A- J1 LDING PERMIT DERANGE IN USE 0 GRADING 0 MANUFACTURED HOME URELOCATION QSIGN [TENANT E]-Of HER OWNER / APPLICANT INFORMATION V OWNER: ( 'e r5 e y l \ L t-te d el c, ® APPLICANT: S A-141 PHONE: 9 L�t �7 7 •5 2. FAX: /2 I 77,, j� PHONE: FAX: ( ADDRESS: 1' 0 r?)4.)1- 6 '"'4.- Lk_ ( c)FiADDRESS: CITY, TATE,ZIP CITY,STATE,ZIP CONTRACTOR: 5(� VIA t:: ® ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# ec) cri 6 i L) 6.co,l°?6 CONTACT: 1-j( Cy l(“ E-. ✓It�r PERMIT/BUILDING INFORMATION COST OF PROJECT: Z�f I �1 30%SLOPES ON PROPERTY: Aid MAIN FLOOR SQ FT: / '/o BUILDING HEIGHT TO PEAK: I et OCCUPANCY GROUP: R. -5 2ND FLOOR SQ FT: BUILDING DIMENSIONS: 7 ' 6 2. CONSTRUCTION TYPE: V N UNFIN BASEMENT: / 7Ci NUMBER OF STORIES: I STRUCTURES ON PROPERTY: ND FINISHED BASEMENT:/ NUMBER of BEDROOMS: Z.- CRITICAL AREAS: .1 'LLQ-. GARAGE: -7 FLANKING SETBACK: 2 CURRENT PROPERTY SIZE: J O 0 X70 COVERED DECK: N r • FRONT SETBACK: 'Z° CURRENT PROPERTY USE: V/\C I t DECK: J REAR SETBACK: 3() CURRENT SEPTIC USE: I'J (,)""lk LEFT SETBACK: P CURRENT WELL USE: RIGHT SETBACK: /0 IMPERVIOUS SURFACE AREA: AINt . MANUFACTURED HOME SIGN WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: IRELOCATION FIRE SAFETY I PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: IWA STATE NON—RESIDENTIAL ENERGY CODE PLANS EXAMINER: PHONE: FAX: ADDRESS:. CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP I SPECIAL INSPECTIONS I 0 BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY 1 1 IS PUBLIC SEWER AVAILABLE: RYES ® NO IF YES: ® COUNTY E CITY IS PUBLIC WATER AVAILABLE: YES ® NO IF YES,WHICH WATER DIST/IRR: C'e' ea" IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO PSSA: 0 YES 0 NO IDATE: I STAFF: , METHOD OF PAYMENT.' 0 �f ® ® .:ISA CASH CHECK L. -- 1 BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE.' *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD an c 1/ �me� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone cry Spokane Valley,WA 99206 509-688-0037-Fax ,,,.Valley Mechanical Permit Application PROJECT /6 2.21 c Th 1....6- - PERMIT Ne t,.,..) floes ADDRESS: S na i, ,119-' I.e(/ W o 95,13- USE: W /3 G 4-1.- 4 T (, OWNER:r� Y / 4 A X40 ''j� PHONE(Daytime Contact):'q 'IC Er /� MAILING ADDRESS! 5 a- y +I° 0 e b e-4r L. + S0 R L I -97.1-2-(street) (city/state) (ZIP) CONTRACTOR: 5: A.,,,, LICENSE#: co-- 5 t P MAILING ADDRESS: PHONE#: 672- 74- (street) (city/state) (ZIP) DESCRIPTION OF WORK I OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE =OR<100,000 X $15 = 2 FUEL BURNING APPLIANCE >100,000 X $19 = 3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 _ X $50 - 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 = 5 USED APPLIANCE(WSEC min.AFUE rating) =or<400,600 X $50 6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 - 7 BOILER/REFRIGERATION 1-100M BTU X $15 = 8 BOILER/REFRIGERATION 101-500M BTU X $28 - 9 BOILER/REFRIGERATION 501-1,000M 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 = 6 a 13 RANGE - X $10 - 1 b 14 DRYER - X $10 = 15 FUEL BURNING WATER HEATER - X $10 = / 0 16 MISC FUEL BURNING APPL. - X $10 - 17 GAS PIPING(ea.Outlet) - X $1 j 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - X $10 = 3 0 , 20 AIR HANDLER(DOES NOT include ducting) =OR<10,000CFM X $12 = 21 AIR HANDLER(DOES NOT include ducting) >10,000 CFM X $19 - 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 - 24 TYPE II HOOD - I X $10 = t 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 - 26 AIR CONDITIONER 3-15 TON X $20 - 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 30-50 TON X _ $35 29 AIR CONDITIONER +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: F.• METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00 -F" TOTAL PERMIT FEE DUE /�i ♦40 L' VISA .t,--2. :,• 0 CASH .7— CHECK 0 =OM 0 '_._- -_ DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Spo'lane 11707 East Sprague Avenue,Suite 106 509-688-0036 Phone Spokane Valley,WA 99206 509-688-0037-Fax Plumbing Permit Application PROJECT /6 Z Z 1 / it L 1Q N Fr, PERMIT t e"v Res : w/3 c rt r 4-11:- ADDRESS: �- USE: � p� Ic.4-►rte 1,41 tc _ OWNER: Ct eG rip 0 ) Aa I If C./ PHONE(Daytime Contact): .y r,r. i3 `' L L L MAILING ADDRESS: 1 21 7 s"2_ 14 (street) (city/state) (ZIP) CONTRACTOR: S A- LICENSE#: q Qv r 5 1_Y� W n ( n A MAILING ADDRESS: PHONE#: -I l� S E(9 92i 9.7s 2.. (street) (city/state) (ail • PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNTTS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS 2, X $6 - / 2 URINALS X $6 - 3 TUBS / X $6 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT _ 2 X $6 - 1 Z,. 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 RAY,FOOD,PREP/CULINARY/MEAT 6 DISHWASHER i X $6 - (p , 7 CLOTHES WASHER I X $6 - 6 • 8 GARBAGE DISPOSAL / X $6 G, 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 $6 - 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 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND X $6 - R.P.B.P.D.FOR:VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM ' X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL X $6 HOLDING TANK = 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 = 20 MISC.PLUMBING FIXTURE X $6 = - SUBTOTAL: METHOD OF PAYMENT .11117a5&041;�- PLUS PROCESSING FEE: $35.00 ] CASH `CHECK 0 NM= 0 _- " TOTAL PERMIT FEE DUE: O rt�Le >ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: . , . , 1 , p/ 4767 • ,..„6„,, 2 O re /F1 er--r 1 o 1•t .. p_ 4 APP'OVED BYs k‘e."----.-- .„,,,,,,,,,,, i io! r R 4 ^ _C P1 in 7/00er'''y a 1 c a ` 4/44 k, . ., , b , . , ed1)/(+ ioor I frit fitto. 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