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2003, 09-30 Permit App: BLD-03-02625 Residence T 1 • T ��r r 'all J 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: /6 3 I J 5'7-11 L rJ /'J e 1 k 4/ `sRc 7 ASSESSOR'S TAX PARCEL NUMBER(S): (7'/6.5-- LEGAL SLEGAL DISCRI PTION: L o T , L O C.T J' 7;41 4)d'o,7z. 77 , S/ 7A &1c p PERMIT DESCRIPTION: J/' if e L (:06 1. 2 -5"1'U R`f U..,!,/ -2 C t r' ®BUILDING PERMIT C CHANGE IN USE GRADING CI MANUFACTURED HOME CE RELOCATION E}SIGN 0 TENANT 0-O'tHER OWNER / APPLICANT INFORMATION OWNER: G e C ( € 14 +�`�� .�-^L- ® APPLICANT: S A-W CJ PHONE: SG�I 9 2 I �7 7 a Z FAX: 2 f 5 7 7 Co l PHONE: FAX: (J ADDRESS: �" ,Q �Z>v `F .6a. 1...4 RC./" 7 L lc LA ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP 9941/? ® . CONTRACTOR: S> A AA ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# 9 620 r5 L1 LA)64. 51 ) CONTACT: J PP r r i !�. Lue on c r. PERMIT/BUILDING INFORMATION COST OF PROJECT: / LAI/ZOO . 30%SLOPES ON PROPERTY: N'3 MAIN FLOOR SQ FT: BUILDING HEIGHT TO PEAK: 2& OCCUPANCY GROUP: R 3 2ND FLOOR SQ FT: 12 •7 9 BUILDING DIMENSIONS: 52 Jl S Z-1 CONSTRUCTION TYPE: V UNFIN BASEMENT: 12 7 J NUMBER OF STORIES: 2. STRUCTURES ON PROPERTY: N C FINISHED BASEMENT: NUMBER of BEDROOMS: " CRITICAL AREAS: N U t k- GARAGE: -7( 1' FLANKING SETBACK: /0 CURRENT PROPERTY SIZE: I Z/o 3 Z. S P COVERED DECK: I\/ FRONT SETBACK: 2 `} CURRENT PROPERTY USE: LMJ U ' PI' L Bow r-- `--( REAR SETBACK: z-15 / CURRENT SEPTIC USE: N C N LEFT SETBACK: /C.) ( CURRENT WELL USE: N D iV RIGHT SETBACK: / U IMPERVIOUS SURFACE AREA: x.10 N T MANUFACTURED HOME SIGN I WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN: YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN: MANUFACTURER: TYPE OF SIGN: l RELOCATION FIRE SAFETY i PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: WA STATE NON-RESIDENTIAL ENERGY CODE i PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP I SPECIAL INSPECTIONS ® BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY 1 IS PUBLIC SEWER AVAILABLE: 0 YES ® NO IF YES: 0 COUNTY ® CITY IS PUBLIC WATER AVAILABLE: 0 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: 0 YES 0 NO PSSA: 0 YES 0 NO IDATE: I STAFF: METHOD OF PAYMENT: 0 ilt ® r 0 �� " VIA CASH CHECK �- -- BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE. *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone "kane Spokane Valley,WA 99206 509-688-0037-Fax Valley 4•00 Plumbing Permit Application PROJECT L (O 3\ \ 1 H^t L.4 KJ c.. PERMIT IL)E LA.; R 6 S' ADDRESS: 5 Q O (c . \/iA-i\4a.4-1 'ir".I IA' 9J 3 7 USE: 2- c ?0 f'f 1....4-11 S c,4_ i` i trr . OWNER cc,cc>> a,.1 e , . tf. PHONE(Daytime Contact):!9 2 / 9 �'•„a_. -re P t`/et. / MAILING ADDRESS: ) p (30 ,c 52- i.— (street) (city/state) (ZIP) CONTRACTOR S (k_vvt z. LICENSE#: W tR 5 / MAILING ADDRESS: PHONE#: 92/ 976 2_ pr--wt (street) (city/state) (ZIP) - PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS 3 X $6 - 18. 2 URINALS X $6 - 3 TUBS '2. X $6 = /Z, 4 SHOWERS(PER TRAP) BATH,STALL,ON-SI I E BUILT ( X $6 - 6. 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR PHOTO,X- & X $6 - 3 6 , RAY,FOOD,PREP/CULINARY/MEAT - 6 DISHWASHER 1 X $6 = Lfo. 7 CLOTHES WASHER / X $6 C. ., B 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 1 X $6 = 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 - t '8 r SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND X $6 - R.P.BP.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 20 MISC PLUMBING FIXTURE X $6 = SUBTOTAL: J 1 44 .a 0 METHOD OF PAYMENT VISA •p.ta , PLUS PROCESSING FEE: $35.00 ] CASH 1f,CHECK 0 =Ma 0 •- TOTAL PERMIT FEE DUE: f hi i.O° >ATE: EXPIRES: ANKCARD NUMBER UTHORIZED SIGNATURE: r 1 S�.t �a 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pokane Spokane Valley,WA 99206 509-688-0037-Fax ,jValley Mechanical Permit Application PROJECT / 6 3 1 1 9 t L.14 t..1 E, PERMIT G.L t'a. sS, ADDRESS: c p G k, V vit-l—k-C_ w A- 9 q O 1 7 USE: V' 'C' sqt OWNER ��%e# r5'� V J N t e- r A f.-.' PHONE(Daytime Contact): MAILING ADDRESS: P_ 0 . (SO bZr e..-a to c r`Ti c. A.id-e- - 5.9'0 17 (street) (city/state) (ZIP) CONTRACTOR --- .. LICENSE it: G te o rl I1c3 , p 9 MAILING ADDRESS: PHONE#: Q 2( �.�a Z (street) (city/state) (ZIP) DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE =OR<100,000 t- X $15 = f J, 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 - I X $10 - j 1, , 13 RANGE - 1 X $10 - )D 14 DRYER - X $10 - 15 FUEL BURNING WATER HEATER - X $10 = ) a 16 MISC FUEL BURNING APPL - X $10 = 17 GAS PIPING(ea.Outlet) - Z X Si - 2 , 18 DUCT SYSTEMS - X $10 - 19 VENTILATING FANS - 4 X $10 - Ito. 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 - ( X $10 - 10 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 = 26 AIR CONDITIONER 3-15 TON ( X $20 - 2 O , 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 1/ 7 ©r METHOD OF PAYMENT PLUS PROCESSING FEE $35.00 r, - ,; TOTAL PERMIT FEE DUE: t a'` , 00 0 CASH *CHECK 0 11111811111 0 L________. DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: