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2003, 10-15 Permit App: BLD-03-02789 Residence CITY OF sè' .001F.Valley PERMIT APPLICATION WORK SHEET SPOKANE VALLEY COMMUNITY DEVELOPMENT BUILDING DIV/S/ON 11707 East Sprague Ave Ste 106 Spokane Valley, WA 99206 .. Phone:(509)688-0036 Fax:(509)688-0037 REQUIRED SITE INFORMATION STREET ADDRESS: 162 16 q ASSESSOR'S TAX PARCEL NUMBER(S): f LEGAL DISCRIPTION: la)T 3 82.,K S. S 1 j/11)4/ e I�11 9iX) PERMIT DESCRIPTION: RAS),O& ' I LIING PERMIT D CHANGE IN USE D GRADING D MANUFACTURED HOME ['RELOCATION• . D-SIGN [TENANT D0tHER IOWNER / APPLICANT INFORMATION 1 0 OWNER: D APPLICANT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: fE3AA CITY,STATE,ZIP - CITY,STATE,ZIP CONTRACTOR: E.14J P m �Se / �" ARCHITECT: PHONE: Qf 90---77 33 FAX: y7 I4I/9 PHONE: FAX: ADDRESS: 16� e. D & €(letAA-T- a 74DDRESS: CITY,.STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# WFP SC.16902C CONTACT: CL 11c-F IPERMIT/BUILDING INFORMATION COST OF PROJECT: /1 30%SLOPES ON PROPERTY:----" MAIN FLOOR SQ FT: 1 /3Z ) BUILDING HEIGHT TO PEAK: & OCCUPANCY GROUP:- 2ND FLOOR SQ FT:- BUILDING DIMENSIONS:5-9)(c(,, CONSTRUCTION TYPE: UNFIN BASEMENT: 1 937., NUMBER OF STORIES: ) STRUCTURES ON PROPERTY: -E)— FINISHED BASEMENT: NUMBER of BEDROOMS: 3 CRITICAL AREAS: GARAGE: s-zir FLANKING SETBACK: CURRENT PROPERTY SIZE: 71/0 COVERED DECK: 'C/ 0'REAFRONT SETBACK: ,Z CURRENT PROPERTY USE: --©-. DECK: -0-- REAR R SETBACK: 3 0 CURRENT SEPTIC USE: LEFT SETBACK: /p CURRENT WELL USE: RIGHT SETBACK: 6 IMPERVIOUS SURFACE AREA: 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: RELOCATION FIRE SAFETY PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP SPECIAL INSPECTIONS ® BOLTING ®CONCRETE ® REINFORCEMENT ® WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: YES ® NO IF YES: 0 COUNTY 0 CITY IS PUBLIC WATER AVAILABLE: YES ® NO IF YES,WHICH WATER DIST/IRR: IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO IS THE PROPERTY LOCATED WITHIN ASA: ® YES ® NO PSSA: 0 YES ® NO IDATE: STAFF: METHOD OF PAYMENT: ® ® ® r 0 ....m. tsbycyd VISA CASH CHECK BANKCARD#: EXPIRES: VIN# AUTHORIZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD (gym ' t 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone ► p+o .ne Spokane Valley,WA 99206 509-688-0037-Fax ,r,00 Valley Mechanical Permit Application PROJECT PERMIT ADDRESS: USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR: 5- tin M mrinV6 LICENSE#: MAILING ADDRESS: PHONE#: • (street) (city/state) (ZIP) DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<100,000 i 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<400,000 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 - l X $10 - 13 RANGE - X $10 - 14 DRYER - X $10 - 15 FUEL BURNING WATER HEATER - ` X $10 - 16 MISC FUEL BURNING APPL. - X $10 - 17 GAS PIPING(ea.Outlet) - 3 X $1 _ 18 DUCT SYSTEMS - X $10 - 19 VENTILATING FANS - 3 x $10 - 20 AIR HANDLER(DOES NOT indude 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 - j X $10 - 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: METHOD OF PAYMENT PLUS PROCESSING FEE $35.00 r 111.0111. IVastth•e " TOTAL PERMIT FEE DUE: ❑ CASH ❑ CHECK ❑ MOM ❑ �--_''-': DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: art c I°r1"111707 East Sprague Avenue,Suite 106 509-688-0036 Phone � Spokane Valley,WA 99206 509-688-0037-Fax 41000 Vailey Plumbing Permit Application PROJECT 4 PERMIT ADDRESS: )6Zz(449 USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (LII') CONTRACTOR: 0..717,i 5 p /` e/Y/[J�I LICENSE S: MAILING ADDRESS: '��/ /� PHONE 5: (street) (city/state) (ZIP) PLUMBING FIXTURES DESCRIPTION DETAILS #OF UMTS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS 'z/ X $6 - 2 URINALS X $6 - 3 TUBS Z X $6 - 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $6 5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 - RAY,FOOD;PREP/CULINARY/MEAT 6 DISHWASHER X $6 - 7 CLOTHES WASHER I X $6 - 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 $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, 3 X $6 - SWAMP COOLER 16 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 $6 - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - ITHOD OF PAYMENT SUBTOTAL: I-- .--, 111.1111111 + ast . P• LUS PROCESSING FEE $35.00 CASH ❑ CHECK ❑ ,p ` -: . _. ==`: - TOTAL PERMIT FEE DUE: TE: EXPIRES: VKCARD NUMBER: THORIZED SIGNATURE: • APPROVED B / 70 3z- I 4111110C1 \ 4 ( (° 22,1-1 qv` imete kellea1 lake 004