2005, 03-16 Permit App: 05000793 Residence Project Number: 05000793 Inv: 1 Application Date: 03/16/2005 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 M
NATURAL GAS Address: 16520 E SECRETARIAT LN
C-S-Z: SPOKANE VALLEY,WA 99037-
Setbacks:Front 25 Left: 8 Right: 7 Rear: 40 Phone: (509)999-7733
Group Name:
Site Information Project Name:
Aar z :: .. .: metwria, ZVg
Plat Key: Name: SHELLEY LAKE 04TH ADD PUD District: East
Parcel Number: 45244.3106 Block: 3 Lot: 6
SiteAddress: 16506 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: ❑
Area: 8,550 Sq Ft Width: 75 Depth: 114 Right Of Way(ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review
Site Plan Review Released By: t tat al
Plan Review Released By: . `
Sewer Review Released By:
f
y
----- --.-- -- -- -
Permits: ..,. giar ,
Operator: K_C Printed By: K_C Print Date: 03/16/2005
Project Number: 05000793 Inv: 1 Application Date: 03/16/2005 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 3418
Building Height 24
Stories 2
Dwelling Units 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq 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
CARPORT U-1 VB 104 $1,560.00 104 $1,560.00
GARAGE U-1 VB 720 $13,680.00 720 $13,680.00
RESIDENCE R-3 VB 1,421 $106,120.28 1,421 $106,120.28
Totals: 4,242 $185,690.96 4,242 $185,690.96
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,475.35
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $590.14
Permit Total Fees: $2,069.99
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: 03/16/2005
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Project Number: 05000793 Inv: 1 Application Date: 03/16/2005 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 $2,069.99 $2,069.99 $0.00 $2,069.99
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $108.00 $108.00 $0.00 $108.00
$2,272.99 $2,272.99 $0.00 $2,272.99
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: 03/16/2005
BUILDING PERMIT APPLICATION WORKSHEET
an' 4011\111% City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
y Spokane Valley, WA 99206
411,Valle
J Phone: (509) 688-0036;Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: I s:D £ W
Assessor's Tax Parcel Number(s): k
J
Leal Descri tion:9 P LO r 8 1,-(K-(K 3 S Re 1 �G. 1 ADD •
PERMIT DESCRIPTION: (2--e-S 1 O-6--n cs
6 Building Permit ❑ Change in Use 0 Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement 0 Fire Safety ❑ Other
I OWNER/APPLICANT INFORMATION
❑ Owner: 0 Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
IP - Contractor: C.L?Sc ,17._ C e►vc r NERP :i'estv
Phone: 4q g-7 ?3 Fax: yl I-9 Ll') I Phone: D Fax:
Address: I (e5 Zt) l 5£L7Le.4-r-v= rrp s
the/e49011-7-4._ GOY+ qqa"2 rc-3)
City State Zip Code State Zip Code
0 � r� uAL
WA State Contractor License#: al le-se-sc.-11)g 2fContact: CLI , P
I PERMIT/BUILDING INFORMATION
HEIGHT TOP K: DIMENSIONS: #OF STORIES:
Z
MAIN FLOOR TO SQ. FTG: 2'"'FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
/y21 , -�,& )S /
FINISHED BASEMENT SQ. FTG: GARAGE SQ. G: DECK/COV. PATIO SQ. FTG:
(, ' V '7Z,0 loLl
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
6e+S
#OF BEDROOMS: , / TOTAL 3 BI TABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 7 30%SLOPS ON PROPERTY: SEWER OR ON-SITE SEP C
0- SYSTEM?
MECHANICAL PERMIT APPLICATION Community Development Department
Building Division
Phone:(509)688-0036;FAX:(509)688-0037 11707 E.Sprague Avenue, Suite 106
diValkY
For Inspections,Call(509)688-0054 Spokane Valley,WA 99206
Project Address: Permit Use:
Owner. Phone(Daytime Contact):
Mailing Address: coy slate zp Code
Contractor: Jam-'We-AA l A--k1 6 license#: Phone#:
Mailing Address: C;g, sire _ 'JP Code
DESCRIPTION OF WORK SOF UNITS X COST = TOTAL AMOUNT
I FUEL BURNING APPLIANCE Equal to or less tan 100.000 ( X $12.00 =
2 FUEL BURNING APPLIANCE More than 100.000 X $15.00 =
3 UNLISTED APPLIANCE(Addro Tal Fee) Equal b or less Oen 400.000 X $50.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 X $100.00 = •
5 USED APPLIANCE(WSEC mit.AFUE rating) Equal to er less flan 400.000 X $50.00 =
6 USED APPLIANCE(WSEC rain.AFUE retina) More than 400.000 X $100.00 =
7 BOILER/REFRIGERATION 1-100M BTU , X $12.00 =
8_ TION 101-500U.B1U X $20.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $25.00 =
10 BORER/REFRIGERATION 1,001-1.750M BTU X 135.00 =
11 BOILER/REFRIGERATION More Ban 1.75011 BTUX 560.00 = ,
12 GAS LOG.GAS INSERT,GAS FIREPLACE 1 X $10.00 =
13 RANGE X $10.00 , =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER 1 X $10.00 =
16 MISC.FUEL BURNING APPLIANCE , X $10.00 =
17 GAS PIPING(eachoutlet) 3 x $1.00 =
18- DUCT SYSTEMS X $10.00 =
j
19 VENTILATING FANS `-/ X $10.00 =
20 AIN HANDLER(DOES NOT ode dam) Equal bar less than 10.000 CFM X $12.00 =
21 AIR HANDLER(DOES NOT include duc0o9) Greater than 10.000 CFM X 515.00 =
22 EVAPORATIVE COOLERS X $10.00 = ,, .
23 TYPErHOOD - 1
X X0.00 =
24 TYPE II HOOD x $10.00 =
25 HEAT.PUWIAIR COMMONER 0-3 TONX $12.00 =
26 AIR CONDITIONER 3-15 TON X $20.00 =
27 AIR CONDITIONER 15.30 TON X 525_00 =
28 Aft CONDITIONER 30-50 TON X 535.00 =
29 AIR CONDITIONER More than 50 TON X $60.00 , _
510.OD =
30 LPG STORAGE TANK X
31 WOOD OR PELLET STOVEIINSERT X , $10.00 =
32 WOOD STOVE-FREE STANDING X $25.00 =
•
X f16N =
33 REPAIR&AOOIT10NS
34 VENTILATION SYSTEMS X $12.00 =
35 VBfilLATION MECHANICAL EXHAUST _ ' X $12.00 =
38 INCINERATOR-RESIDENCE . X $19.00 a
37 NUMERATOR-COMMERCIAL X 122.00 s
METHOD OF PAYMENT: SUBTOTAL
0 CASH 0 CHECK 0 VA OMC
DATE
ISPROCESSING FEE $35.00
EXPIRES:
CARD is TOTAL PERMIT FEE DUE:
AI ITH0R17F0 SIGNATURE
PLUMBING PERMIT APPLICATION Community Development Department
swine,
Building Division
Phone: (509)688-0036;FAX: (509)688-0037 11707 E. Sprague Avenue, Suite
106
For Inspections.Cali(509)688-0054 Spokane Valley, WA 99206
delnalleY
Project Address: .' Permit Use:
Owner: Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: I PIM ,s P L t 1 it l ISI A)G License#: Phone it:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK 6 OF UNITS X . COST = TOTAL AMQUNT
1 TOILETS WATER CLOSET.BIDETS S X $6.00
2 URINALS � X $6.00 . _ ,
3 TUBS C/ X $6.00 = ,
4 SHOWERS(PER TRAP) BATH STALL,ON-SITE BUILT •1 x $600 =
tAVSIBASINS,BAR.FLOOR.IOTCHEN. =
5 SINKS LAUNDRY,UTIUTY.JANITOR.PHOTO.
X $6.00
X-RAY,FOOD.PREP1C1XINARY MEAT
6 DISHWASHER 1 • X . X00
7 CLOTHES YMASHER I X $600 =
8 GARBAGE DISPOSAL I , X $600 =
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 1 i X $6.00 =
ROOF DRAINSIOVERFLOW
12 DRAINS X $6.00 =
13 FOUNTAINS,DRIINGING X $6.00 , _
WATER PIPING/DRAIN-IN WASTE, NSTALLATKXN,ALTERATION,REPAIR,
14 VENT,PLUMBING.REVERSAL REVERSALS X $6.00 =
15 SEWAGE EJECTOR GRINDER SUMP PUMP X $6.00 =
ICE AMOR 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 RP.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 =
GREASE TRAP,SAID TRAP,
18 NTERCEPTORS CHE N1CAL HOLDING TANK X $600 =
19 MEDICAL GAS(per 0u6e9 NITROUS,OXYGEN X 1600 =
MISCELLANEOUS PLUMBING
20 FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAUSYSX $20.00 _=
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
/ L This site plan is being submitted for the
obtaining a building permit and is
propert
oce reas� representation Purpose of
of the proposal a true and correct
lines/dimensions,curb lin-s,structures
known
LIMIM
have been identiti d o i r4ctures and easements
....46.--..
bodies of a r, e I are wetlands,
cO111111111.1111A , . r s ' ► critical
'mow le
Signed: —iii//o�1� a areas.
REw 1L-
Date:
• 1011.5-1Ce
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