2005, 04-28 Permit App: 05001355 Residence •Project Number: 05001355 Inv: 1 Application Date: 04/28/2005 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 30 Left: 5 Right: 20 Rear: 27 Phone: (509)999-7733
Group Name:
Site Information: Project Name:
Plat Key: Name: SHELLEY LAKE 04TH ADD PUD District: East
Parcel Number: 45244.3101 Block: 3 Lot: 1
SiteAddress: 16402 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: 11,199 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review tJMUI Site Plan Review Released By: -
Plan Review Released By: t A trh
IAA.,'
Sewer Review
Released By; - 9- _
Permits:
Operator: K_C Printed By: K_C Print Date: 04/28/2005
Project Number: 05001355 Inv: 1 Application Date: 04/28/2005 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 3454
Building Height 14
Stories 1
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Su Ft Valuation Sq Ft Valuation
BASEMENT U R-3 VB 1,727 $25,905.00 1,727 $25,905.00
CARPORT U-1 VB 54 $810.00 54 $810.00
GARAGE U-1 VB 572 $10,868.00 572 $10,868.00
RESIDENCE R-3 VB 1,727 $128,972.36 1,727 $128,972.36
Totals: 4,080 $166,555.36 4,080 $166,555.36
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,368.95
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $547.58
Permit Total Fees: $1,921.03
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 3 NUMBER OF $30.00
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: $85.00
Operator: K_C Printed By: K_C Print Date: 04/28/2005
Project Number: 05001355 Inv: 1 Application Date: 04/28/2005 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 2 NUMBER OF $12.00
SINKS 3 NUMBER OF $18.00
SHOWERS 1 NUMBER OF $6.00
TUBS 1 NUMBER OF $6.00
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: $84.00
Payment Summary•
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $1,921.03 $1,921.03 $0.00 $1,921.03
Mechanical Permit $85.00 $85.00 $0.00 $85.00
Plumbing Permit $84.00 $84.00 $0.00 $84.00
$2,090.03 $2,090.03 $0.00 $2,090.03
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: 04/28/2005
= BUILDING PERMIT APPLICATION WORKSHEET
CITYSPokalle
- City of Spokane Valley Community Development Department
. , _
,„--,
Building Divisional I.t
C 11707 E. Sprague , Suite 106
D Avenue
.0.0 •
_)D
Spokane Valley, WA 99206
7, Phone: (509) 688-0036; Fax: (509) 688-0037
D
o Wal1k4INFORMATION
•
Street Address: /64/02 1. q
if-4
Assessor's Tax Parcel Number(s):
Legal Description: Le 7-1 3L K_3 s /kir /7k ' 7 /5V,
PERM DESCRIPTION: leek /De")e..ta�
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement El Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
r
•
❑ Owner: ❑ Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
iContractor: 61.t FF SC,t*b .117... ❑ Architect:
Phone:97733 Fax: g431-‘14M) Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
• WA State Contractor License#:CLk'C"FSG t 0I-I Q F Contact: e.,1,
Spokane Valley Bus. Liles ense #: Contact:
N PERMIT/BUILDING INFORMATION I
HEIGHT TO 1P�AK: DIMENSIONS:�s #OF�ORIES:
MAIN FLOOR TO SQ. FTG: 2 FLOOR SQ. FTG: UNFIN B MENT SQ. FTG:
i rZr) -O iI/! f72'7
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV.PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABI A4B,L�SPACE: IMPERVIOUS FACE AREA:
COST OF PROJECT: 30%SLOIEA ON PROPERTY: SEWER OR ON-SITES,EPTIC
SYSTEM? S-P.<AJ`eii(
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
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
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):
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 ordinances.
Ownership of resulting development rights granted by any issued permit inure to the property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
As%'I' PLUMBING PERMIT APPLICATION Community Development Department
aNe
Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
, soya}, For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: Permit Use:
Owner. e_,L2rAP Selo Wt Phone(Daytime Contact): QR q-7 7.3.3
Mailing Address: _
City State Zip Code
Contractor. License#: Phone#:
Mailing Address: T'IMft1U{ S 01144,111.6i 14)6
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST a TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $6.00 =
3 TUBS / X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X' $6.00 =
LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER ) X $6.00 =
7 CLOTHES WASHER X $6.00 =
8 GARBAGE DISPOSAL I X $6.00 =
9 WATER SOFTENER X $6.00 =
10 ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X $6.00 =
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE ` X $6.00 =
ROOF DRAINS/OVERFLOW
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 X $6.00 =
PROOFER,CARBONATOR,SWAMP COOLER J
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 DISPOSAUSYS X $20.00 =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
❑ CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION Community
someDevelopment Department
" Building Division
aoll
J 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:
n,� City State Zip Code
Contractor: _Si -1'Y1 462 1 A) é License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X , $12.00 =
2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 =
3 UNLISTED APPLIANCE(Additional Fee) Equal to or 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/REFRIGERATION 1,001-1,750M BTU X $35.00 =
11 BOILER/REFRIGERATION More than 1,750M BTU X $60.00 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE t X $10.00 =
13 RANGE X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER I X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) _3 X $1.00 = _
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS 3 X $10.00 =
20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10,000 CFM X $12.00 =
21 AIR HANDLER(DOES NOT include ducting) Greater than 10,000 CFM X $15.00 =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD X $50.00 = _
24 TYPE II HOOD I x $10.00 =
25 HEAT PUMP/AIR CONDITIONER 0-3 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 EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCE X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL
❑CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#. EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
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