2005, 01-21 Permit App: 05000205 Residence Project Number: 05000205 Inv: 1 Application Date: 01/21/2005 Page 1 of 3
TIIIS 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 M
NATURAL GAS Address: 16520 E SECRETARIAT LN
C-S-Z: SPOKANE VALLEY,WA 99037-
Setbacks: Front 25 Left: 8 Right: 10 Rear: 38 Phone: (509)999-7733
Group Name:
Project Name:
Site Information:
Plat Key: Name: SHELLEY LAKE 04TH ADD PUD District: East
Parcel Number: 45244.3103 Block: 3 Lot: 3
SiteAddress: 16414 E 9TH LN Owner: Name: SCHMITZ,CLIFFORD M
Address: 16520 E SECRETARIAT LN
Location::CSV SPOKANE VALLEY,WA 99037-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: El
Area: 9,977 Sq Ft Width: 0 Depth: 0 Right Of Way(ft): 32
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Site Plan Review Released By 1IL
Plan Review
Sewer Review 'Released
- 77-tad,(47
Operator: K_C Printed By: K_C Print Date: 01/21/2005
Project Number: 05000205 Inv: 1 Date: 01/21/2005 Page 2 of 3
� Application
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 3418
Building Height 23
Stories 2
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes So Ft Valuation So Ft Valuation
2ND FLOOR R-3 VB 576 $43,015.68 576 $43,015.68
BASEMENT U R-3 VB 1,421 $21,315.00 1,421 $21,315.00
COV DECK R-3 VB 104 $1,560.00 104 $1,560.00
GARAGE U-1 VB 740 $14,060.00 740 $14,060.00
RESIDENCE R-3 VB 1,421 $106,120.28 1,421 $106,120.28
Totals: 4,262 $186,070.96 4,262 $186,070.96
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,480.95
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $592.38
Permit Total Fees: $2,077.83
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 4 NUMBER OF $40.00
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: $95.00
Operator: K_C Printed By: K_C Print Date: 01/21/2005
Project Number: 05000205 Inv: I Application Date: 01/21/2005 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 3 NUMBER OF $18.00
SINKS 5 NUMBER OF $30.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
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: $108.00
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $2,077.83 $2,077.83 $0.00 $2,077.83
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $108.00 $108.00 $0.00 $108.00
$2,280.83 $2,280.83 $0.00 $2,280.83
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: 01/21/2005
BU ,ING PERMIT APPLICATION WORKSHEET
CITYOU E. C ,11314*, i alley Community Development Department
Building Division
4,000
\ i11e q, JAN 1 q 2005 11707 E. Sprague Avenue, Suite 106
V Spokane Valley, WA 99206
�J D DIA
ne: (509) 688-0036;Fax: (509) 688-0037
I REQUIRED SITE INFORMATION
Street Address: /6 CO 1/ , q 'ri
Assessor's Tax Parcel Number(s): c's- Z `/q, 3 /03
Legal Description: LID T—3 8 L./ 3 5 1-k1ler ) K, /)Gbl
PERMIT DESCRIPTION: ICS Oen et
VBuilding Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety 0 Other
OWNER/APPLICANT INFORMATION
0 Owner: ❑ Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
[e/'
Contractor: el- SG Dom► l'T? Y 1 ❑ Architect:
Phone:a ti 4 7'7s 3 Fax: v /-Q v71 Phone: -ax:
Address: I s-zo £- 5--.Cge. A-r-kr Address:
titelr [.AJ ''o57
City State Zip Code City State Zip Code
WA State Contractor License #:al i-.'Se i -i rZ r Contact: (2)--- I F
N PERMIT/BUILDING INFORMATION O
HEIGHT TO EAK:i DIMENC.S �SIIOS:� d #OF STIES:
MAIN FLOOR TO SQ FTC: 2""FLOOR SQ. FTG: UNFIN BA EMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ.G: DECK/COV.PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
(D
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
4— SYSTEM? 5 )€1'Z
PLUMBING PERMIT APPLICATION Community Development Department
,,.,, / Building Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
#Valley For Inspections, Call (509)688-0054 Spokane Valley, WA 99206
•
Project Address: Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
%Contractor: T PINY S P�f� .67 Ai 6 License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK It OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET.BIDETS j 3 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. .,J X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER I X $6.00 =
7 CLOTHES WASHER j 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 I 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
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 Development Department
sf11tn# \ Building Division
'��70° 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:
Car State Zip Code
Contractor: •S -ten\ '&T-] h.► ( License#: Phone#:
Mailing Address:
City Site Zp Code
DESCRIPTION OF WORK I OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 I 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 nun.AFUE rating) Equal to or less than 400.000 X $50.00 =
6 USED APPLIANCE(WSEC nun_AFUE rating) More than 400,000 X $100.00 =
' 7 BOILER/REFRIGERATION 1-100M BTU X $12.00 =
8- BOILERIREFRIGERATION 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 I X $10.00 =
13 RANGE X $10.00 , =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER • l X $10.00 =
16 , MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) :9 X $1.00 =
18-- DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS q 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 STOVEANSERT 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
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
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