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2004, 02-19 Permit App: BLD-04-03586 Residence sboryland,e\,, 400 AValley 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 40' STREET ADDRESS: / ,3 Z �t c • 1 ( L4 //__ jj ASSESSOR'S TAX PARCEL NUMBER(S): ' IS 2`�, , 9 (J 5� (( f LEGAL DISCRIPTION: L. / Ck'C ' A d s f I ! PERMIT DESCRIPTION: C ; i4 L-A.) / 3 .4 r FA " Ce r (01/4' rr 'UILDING PERMIT C_CHANGE IN USE 0 GRADING 0 MANUFACTURED HOME a RELOCATION 0 SIGN E TENANT 0-0 IIIER OWNER / APPLICANT INFORMATION f ® OWNER: '"r jt, 7fb iter . �,.v94 'f✓ ® APPLICANT: OS A PHONE: ` i'AX: PHONE: FAX: ADDRESS: J ` ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP ®CONTRACTOR: S P' Ink E'--_) ARCHITECT: PHONE: FAX: PHONE: FAX: ADDRESS: ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# e U P L.,) 6,9 I"' CONTACT: I e f C,1 9 9' 7 PERMIT/BUILDING INFORMATION COST OF PROJECT: / 2 t) 00 0 30%SLOPES ON PROPERTY: I"..' MAIN FLOOR SQ FT: J 6`jS BUILDING HEIGHT TO PEAK: 2 0 OCCUPANCY GROUP: R t 2ND FLOOR SQ FT: ✓— BUILDING DIMENSIONS: 4(0 14 CONSTRUCTION TYPE: V IV UNFIN BASEMENT: �/ NUMBER OF STORIES: STRUCTURES ON PROPERTY: N° FINISHED BASEMENT: NUMBER of BEDROOMS: Z. CRITICAL AREAS: GARAGE: O z FLANKING SETBACK: CURRENT PROPERTY SIZE: / /,7 7 0 S 1= COVERED DECK: I'J 0 FRONT SETBACK: 'I I CURRENT PROPERTY USE: U 4 C.. f DECK: J 7 REAR SETBACK: 5`( 3 CURRENT SEPTIC USE: LEFT SETBACK: ( 2 CURRENT WELL USE: RIGHT SETBACK: I IMPERVIOUS SURFACE AREA: --- MANUFACTURED HOME SIGN WIDTH: r 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: 1 WA STATE NON-RESIDENTIAL ENERGY CODE _ I PLANS EXAMINER: PHONE: FAX: ADDRESS: CITY,STATE,ZIP INSPECTOR: PHONE: FAX: ADDRESS: CITY,STATE,ZIP SPECIAL INSPECTIONS 0 BOLTING ®CONCRETE 0 REINFORCEMENT 0 WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: ® COUNTY 0 CITY IS PUBLIC WATER AVAILABLE: 0 YES 0 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 ® NO IDATE: I STAFF: ' METHOD OF PAYMENT: T 0 .....•® CASH CHECK ® L imM mim BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD 0(371t 0111 �usrrsi 11707 East,Sprague Avenue,Suite 106 509-688-0036-Phone pO ne Spokane Valley,WA 99206 509-688-0037-Fax jValley Mechanical Permit Application PROJECT ‘ (Ce '3 *9 CI,N 1,•10e PERMIT .t 4, N' r e3. C 4. O vi-t. . (-4 K A•-Is C Ll ADDRESS: 4?t.k.,./ '„.w3 4_ , <,,. ;u,, .. ' • ' ri USE: {s..Y r )44,41 if OWNER: PHONE(Daytime Contact): --- t*c tr`� MAILING ADDRE�` a , _ p�. 9 C "4/6 y 6 Cc .:Jtg: ,r7,.. I,p/64_, �£;. sej xdX. (7 rt (street) - (city/state) (ZIP) CONTRACTOR: �` t t" �}�` Ij LICENSE#: E "—lex MAILING ADDRESS: PHONE#: (r (street) (city/state) (ZIP) DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<100,000 ( X $15 - ) 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 - 1 X $10 = J U 13 RANGE - d X $10 - i () 14 DRYER - X $10 = 15 FUEL BURNING WATER HEATER - If X $10 - /0 16 MISC.FUEL BURNING APPL. - X $10 - 17 GAS PIPING(ea.Outlet) - 2 X $1 - '7-- 18 DUCT SYSTEMS - X $10 - 19 VENTILATING FANS - 3 X $10 - 3 C: 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 - 1 X $10 = / v 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: 0 ' METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00 115.4 .=OM � I TOTAL PERMIT FEE DUE: i 22 0O' 0 CASH CHECK 0I 0 T_ DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: CSc�r4 cx .'/ 11707 East Sprague Avenue,Suite 106 509-688-0036 Phone pokane Spokane Valley,WA'99206,' 509-688-0037-Fax I0Valley Plumbing Permit Application PROJECT l (Q 3 rr2 3 972' L a4 N G PERMIT Rif S i 0.e-Y,7 f rC 4 ADDRESS: 'S.ane.L ke`l LA ke , S p<3 tc Vri( te'„;:37uSE: 3 c ul r 1,411 rL, 641(! IAC (,t OWNER: PHONE(Daytime Contact): '�P i ref MAILING ADDR s,q�8 c �' � _ a vei ire r„. 4 L.e9 ,7a:r„ (street) - ) (city/state) (ZIP) CONTRACTOR: ,.T a .', c0 00 19 LICENSE#: q. ,g) t` s MAILING ADDRESS: PHONE#: (`�`aOq) '- 2/ 7a C- CS (4 t.."Ae. ) (street) (city/state) (LU-') PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS 2 X $6 = / 2 URINALS X $6 = 3 TUBS 7.- X $6 - I L, 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT t X $6 - CC 5 SINKS LA VS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- 14 X $6 - 2 L// RAY,FOOD,PREP/CULINARY/MEAT 6 DISHWASHER ( X $6 = (P 7 CLOTHES WASHER I X $6 - C 8 GARBAGE DISPOSAL / X $6 - uPi 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 • C< 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, t X $6 - SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR:VATS,TANKS,BOILERS X $6 17 X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL X HOLDING TANK - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: 64 -;; METHOD OF PAYMENT I}?k t PLUS PROCESSING FEE $35.00 0 CASH (; CHECK 0 Man 0 •._.- .7-'1. --_= TOTAL PERMIT FEE DUE: / 19, ° DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: • • . . . . . 1), • , . .. , , .... 1 1 6.' 4° ' , r ., 0.. , • Y• u3 29 0 4 0 11 A , a. 9-4 .i,•-'k - (4 . . .‘,.. \ , 141 (1." .....• • ..,. .,. , . . .• • '•;*. ::: '''''2-.1--:••-• ,' ..;:;. . ,, .. fg) .......• .- . •at. , •'1‘ AV • ::t: •4,•.•;k, . ..., '-.%• ... • '1' -i • . '.., , •1'- ••• .17•`•*•. 77( • Vilill 1 • . r.e• , ;" ':•;•: _. .._, .___,..L___, ., ,___7' , \. ... iAl- -,, . _ '''Ct . . _ --• 1'. i a • . LiI ft •••• . NI, ,,e\ Vi al'• ".."..4.. / in Lf) • . i. .,...-- tl--r"----'--------'e - .- : ., .......ie J\44% '' .. ,,,-- , I to . „--... -... I 00 Z7 , .••, r A n 0) ,........,) ..4: . ro .r.-- T..... ko 11Plb ' . I, 1 ci4 . --,.. . _ • * .„.. .. . 13.50 1 .. 11.1. . \\ CP _ . _ _ .•.. . - • , all . C2 . c f ' --' • .v, 68. 0 .. . , . • • . . __, _ 24. 51 -_ . . PLANNING DEPT.APPROVED . . . / A DATE: (9 • .0' , — 9/V I 1,114A-L—a I' • • P11-144 CJ2-e -,2—J, &&1—(--/j , •• .... ... . . , • . . •