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2004, 03-25 Permit App: BLD-04-03888 Residence Sliaan'#e\II' 1 ValeY ' 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: /o' / 3 c.' 9 i:_:4 Z. i4 N.: 2 A fie ," J L 14 /C S'eo 1c V►'� R (' -37 ASSESSOR'S TAX PARCEL NUMBER(S): � ZLI/ . 2 6 Q 9 � 7 LEGAL DISCRIPTION: L0 T (p ('7 Lr)c iC Z 41 41 Ad8 c±i E 10 PERMIT DESCRIPTION: /k/I LA.) 0 e S', U /3 CA-r (4-ft GA. r. P,,,( ( 3 4- r e 6� atRUILDING PST O CHANGE IN USE 1 GRADING I]MANUFACTURED HOME D-RELOCATION aSIGN aTENANT EtatHER 1 OWNER / APPLICANT INFORMATION 1 OWNER: 6.7^ ,;':;.,11,7e -- w• r w Die. S'® APPLICANT: / vi Z PHONE: ,- FAX: PHONE: FAX: r ADDRESS r s ' ADDRESS: CITY,STATE,ZIP CITY,STATE,ZIP °CONTRACTOR: IA VIA CL- ARCHITECT: PHONE: FAX: c/a I ''77(I,„ PHONE: FAX: ADDRESS: ADDRESS: � CITY, Q/ s .STATE,ZIP / NC�1CP CITY,STATE,ZIP WA ST CONTRACTOR LICENSE# 9 �L7 r, n Vv 6.9/P8 CONTACT: - e r•/ C'3L tie PERMIT/BUILDING INFORMATION COST OF PROJECT: /3/ w 30%SLOPES ON PROPERTY: - MAIN FLOOR SQ FT: / t?g 7 Stc / , BUILDING HEIGHT TO PEAK: /9,(o OCCUPANCY GROUP: R 2 2ND FLOOR SQ FT: BUILDING DIMENSIONS: 56'ix (03 ' CONSTRUCTION TYPE: ��I\) UNFIN BASEMENT: / g/a s F NUMBER OF STORIES: I STRUCTURES ON PROPERTY:j-v ge FINISHED BASEMENT: NUMBER of BEDROOMS: 3 CRITICAL AREAS: GARAGE: OU 2- 5 P FLANKING SETBACK: --- CURRENT PROPERTY SIZE: /Z(7`?8 S R COVERED DECK: N/A / FRONT SETBACK: 2 Z ' CURRENT PROPERTY USE: L/l Alk)1 DECK: /2 xC /`7 REAR SETBACK: G//• 0 / CURRENT SEPTIC USE: ! - /i I LEFT SETBACK: / V CURRENT WELL USE: NM i RIGHT SETBACK: /CP IMPERVIOUS SURFACE AREA: --- 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: I RELOCATION FIRE SAFETY PREVIOUS ADDRESS: FIRE SPRINKLER: FIRE ALARM: PAINT BOOTH: TENT: PROPOSED USE: FIREWORKS DISPLAY: BLASTING: DATE/TIME: 1 WA 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 ® REINFORCEMENT ® WELDING FIRM NAME: PHONE: FAX: INSPECTOR(S): BUILDING STAFF USE ONLY IS PUBLIC SEWER AVAILABLE: ® YES ® NO IF YES: a COUNTY ® CITY IS PUBLIC WATER AVAILABLE: a 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: I METHOD OF PAYMENT: 0 �■�i a K ® ' WM CASH CHECK Lmionim BANKCARD#; EXPIRES: VIN# AUTHORIZED SIGNATURE: *FAXED PERMIT APPLICATIONS WILL ONLY BEACCEPTED WITH MAJOR BANKCARD S(�cJT1 c ! �uw� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone po ; ne Spokane Valley,WA 99206 509-688-0037-Fax do,*Valley Mechanical Permit Application PROJECT /to yo 3 �j/ L (n e PERMIT / ,, ,QQ S c_4_, /3 cpk,e` ADDRESS: 5 LI e ( (e`. Lk_ S(.c)lc (f i.( 9%3 7 USE: � Ai?f C70 r' OWNER:/-7_. c' ! / �hi' /t /�C T/e -7,,,,_-7,,,,_ PHONE(Daytime Contact): J>J Z MAILING DRESS: Pc (>o)( 5 2__ erry a (..., .e_— (street) (city/state) t_t Ler1,7k.. (ZIP) 9 9so 77 CONTRACTOR: > LICENSE A: 9.,7v t__ ‘i:' zQ .7/108 MAILING ADDRESS: PHONE I: (street) (city/state) (ZIP) DESCRIPTION OF WORK #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 S50 = 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 - iX $10 = /() 13 RANGE - / X $10 = i 0 r 14 DRYER - X $10 = 15 FUEL BURNING WATER HEATER - ! X $10 - /v r 16 MISC FUEL BURNING ADPL. - X $10 = 17 GAS PIPING(ea Outlet) - 2 X $1 - z r 18 DUCT SYSTEMS - X $10 = 19 VENTILATING FANS - _'` X $10 = jam, 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 - / X $10 = /U. 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: e7 METHOD OF PAYMENT PLUS PROCESSING FEE: $35.00 ", Yom. } kms .' TOTAL PERMIT FEE DUE: /Z2,0) 0 CASH CHECK 0 0 t______= DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: rn4�x 11707 East Sprague Avenue,Suite 106 509-688-0036 Phone Sgol �ane • Spokane Valley,WA 99206 509-688-0037-Fax 1ey Plumbing Permit Application PROJECT I Co`i O 3 a.S r�i 4-4 N127 PERMIT Al P c--, k' 'S (---)73 c,/'' ADDRESS: 5`n e(lei.( L r k. S io!e- VA-11,4/ 9537 USE: /7 7r 63,4 r. OWNER: Geo 4rci i-k WA„IV a,,,,` _ PHONE(Daytime Contact): 9 2 f of 7,52 MAILING ADDRESS: e._0. 36--/- oZ L t 6er7'1/4/ LLk (street) (city/state) /, ,4 9 fp/ (ZIP) 6)0,j2_ CONTRACTOR .5 f e_ LICENSE#: 1 Ec--) /`7"1/ w 49 7>i° Z� r? MAILING ADDRESS: PHONE 1: 72-/ 9702_ (street) (city/state) (Zn') ' PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS 2- X $6 - /2.- 2 URINALS X $6 - 3 TUBS Z X $6 = /2 , 4 SHOWERS(PER TRAP) BATH,STALL ON-SITE BUILT / X $6 - ep . 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 - 3 c) RAY,FOOD,PREP/CULINARY/MEAT 6 DISHWASHER / X $6 - 6 . 7 CLOTHES WASHER / X $6 - Co , 8 GARBAGE DISPOSAL / X $6 - 4p- 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 - 1p 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: ck a' v1ETHOD OF PAYMENTMEM 4f. ty i; PLUS PROCESSING FEE: $35.00 CHECK 0 MININ ❑ .-._ TOTAL PERMIT FEE DUE: /2 �.. )ATE: EXPIRES: 3ANKCARD NUMBER: WTHORIZED SIGNATURE: • ID117Z ' Sr— fit 0 I 0 0 I ti •F 0 a ADDRESS r. I �� �' 1t g D ZONE AD WIDTH 2 _ � � �-' RONt _ F� - ���, 7 CO MENTS 7 V� � !!d�� RE IEWEDBY �r/1f�•l, V This ;ite plan is being submitted for the purpose f j Jv ob ining a building permit and is a true and torr r •resentation of the proposal. All known y I Ines/dimensions,curb lines,structu and e s have been identified. Also • are we I , bodieCs e1 water, steeps critical are . \ II "(----r-riA_ , Signed: .,_......S.1.._Date: d• j Viir d I 1 0 ciN ( '" 7.) O ,(\:: I '+ cr a , 6(----- 11 , ,, { .„- , ::)ILzki RuS , ki tid 'la torr of �'d/1<ir• ►C �!' f6 p�,_rr I lCt"1Perlyl, ..::, l yNs :4Is 1\ i Q'y I ,� ,� ' t 1..., 3 9. f3 ' L(Q 41.0 3 E 9 tph _ -_ w_ E ,_ _S_I H _L ..pt\ L_-o t',_._ .__ _ .._ ` ... _ , wf.. " A d_ .__ � _ _ .ff ____C�c_ 4\ _ . + N_ e.______.________ \AVi .* tv,c, 9 2 ► 5 25, ...e.._... ..