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2004, 06-16 Permit App: BLD-04-04616 Residence BUILDING PERMIT APPLICATION WORKSHEET crn'oF SpokaneCity of Spokane Valley Community Development Department Building Division ' 40000ValleY 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036;Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: ,t-/D ID' E _.. Assessor's Tax Parcel Number(s): -16:,/13. A )c 3 Legal Description: Tr ct 'C S i d r f Plat o o --a'3 r PERMIT DESCRIPTION: Ai-Pc-0C.d to 10.A,GTf 1 d A g Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION ❑ Owner: ❑ Applicant: Phone: Fax: Phone: Fax: Address: Address: City State Zip Code City State Zip Code NContractor: wWirtz zrL Wi CDAar IA/G. ❑ Architect: Phone: 2qq-49c.q Fax: zq1-(044 Phone: Fax: Address: 1o403 S. ceaacrrt /e, Address: MFt rciu ZAKE I./ASN 9f022 City State Zip Code City State Zip Code e` \v)-1)/0 417 .Y-/ WA State Contractor L'cepr se #: Wyrrr g74 NS Contact: 46)441a', PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: c 1 A- DIMENSIONS aX36- #OF STORIES: / MAIN FLOOR TO SQ. FTG: 2""FLOOR 940 SQ. FTG:6 UNFIN BASEMENT SQ. FTG FINISHED BASEMENT SQ.FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG: OCQUMNCY OUP: CONSTRUCTION TYPE: H T SOURCE: 5/L 4 F�(ly CO�o ( s #OF BROOMS: TOTAL HABITABLE SPAC : IMPERVIOUS SURFACE AREA: COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC-/ 0 SYSTEM? S /Yf - S y5Tri14 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 El BOLTING El CONCRETE El 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 El Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: • Inspections performed 10 days after scheduled completion to schedule call (509)688-0195 or Fax(509)688-0037. Any re- inspection will incur an additional $25.00 charge. 11707 E Sprague Ave, Suite 106 400000, Spokane Valley,WA 99206 ROW Construction Permit Permit# ROW 04-409 Issue Date 6/16/2004 Account# Completion Date Issued by Construction Utility Location of Property Project Description 14310 E 10th AVE driveway Comments New construction of driveway Trench Dimensions AC Cut Required Applicant/Contractor Name Licence# Individual Name White Water Construction Address Contractor Phone# 10403 S Granite Dr Medical Lake WA 99022- Account# Permit Fee Inspection Fee Total Fees Collected $25.00 $25.00 $50.00 Permittee Signature Approved Date I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Credit Card# Expiration Date Name of Holder Signature In addition to the permit application fee of$16.00(utility)or$25.00(construction), inspection on each permit will be billed to the permittee at a rate of$50.00 per hour with a$25.00(1/2 hour) minimum. Permittee signature constitutes an agreement to these terms and provisions. Work completed satisfactorily(signed) Date PERMIT MUST BE KEPT ON SITE • PLUMBING PERMIT APPLICATION 0#\IICity of Spokane Valley Community Development Department BuildingDivision galley 11707 E. Sprague Avenue, Suite 106 del Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address: f Permit Use: Owner: /A-1.‘,1 P �,t�a -�e v Cc1. ! ut c. Phone (Daytime Contact): ,299-4-9.(c, Mailing Address: /04O 3 S_ �isck je Dr, )'liVet,cGiL Lt/6-e Wu- 96102- ( City State Zip Code Contractor: F(A.C-e'fs -N- STc t License#: �c�(.�c e t5' 31Phone#: Mailing Address: P.o. Qd c 5p041Lt. 04(1,e) cock `.?7 City State Zip Code #OF TOTAL DESCRIPTION OF WORK UNITS X COST - 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 X $6.00 = 5 SINKS LAVSBASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT -- - 6 DISHWASHER / X $6.00 = 7 CLOTHES WASHER / X $6.00 = 8 GARBAGE DISPOSAL 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, X $6.00 = CONDENSATE _ 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 15 SEWAGE EJECTOR . GRINDER,SUMP PUMP J X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X $6.00 = CARBONATOR,SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR: X $6.00 = VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: SUBTOTAL Q CASH 0 CHECK Q VISA Q MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: MECHANICAL PERMIT APPLICATION *l^ „e104.°\ftiCity of Spokane Valley Community Development Department ane BuildingDivision le Y 11707 E. Sprague: Avenue, Suite 106 ..•OVal Spokane Valley, WA 99206 Phone (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address(( Permit Use: Owner: LAA 1 L. ti/A_ L'G►.51%. (Ac., Phone (Daytime Contact): Mailing Address: k,46 4 c . 64,40 ti-..e flr, t4 J c�-r kok-e foci . fye,22- City State Zip Code Contractor: n ..., I i bAL License#: Phone#: Mailing Address: 16.6. , )ii /, 4(, ( , 9D2 City State Zip Code #OF TOTAL DESCRIPTION OF WORK UNITS X COST = AMOUNT 1 FUEL.BURNING APPLIANCE Equal to or less than 100,000 r X $15.00 = 2 ' FUEL BURNING APPLIANCE More than 100,000 X $19.00 = 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 = USED APPLIANCE(WSEC min.AFUE 5 rating) Equal to or less than 400,000 X $50.00 = USED APPLIANCE(WSEC min.AFUE 6 rating) More than 400,000 X $100.00 = 7 BOILER/REFRIGERATION 1-100M BTU X $15.00 = 8 BOILER/REFRIGERATION 101-500M BTU X $28.00 = 9 BOILER/REFRIGERATION 501-1,000M BTU X $39.00 = 10 BOILER/REFRIGERATION 1,001-1,750M BTU X $57.00 = 11 BOILER/REFRIGERATION More than 1,750M BTU X $95.00 _ 12 GAS LOG,GAS INSERT,GAS FIREPLACE / 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 / 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 $19.00 = 22 EVAPORATIVE COOLERS X $10.00 23 TYPE I HOOD X $50.00 = 24 TYPE II HOOD l X $10.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON i 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 = 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: D .0f ! S`O4 c,�c r-e roe."--c41 41 )._40.4- Size 8a.s- . JS - tet s 1‘r,r-F NA. e 4 00' a 4 a • .. - A . , . • • 1 i 6. This ells plan is being submitted for the purpose of obtaining a building womb and is a 1[w and correct fines/dimensions.euro known property have t identified. easementsllands bodies of indicated are w , edands �!p , . Or other critical aeras. Signed- e( -- %v Date: 1— Ar,—40 . • A I n Zn vi PI lk-) cl: . 1 eck $, ,,4_ 1 _ i 1111Dig �. • Dir.‘ e ZONE ss ROAD Wl FRONt? P1,ANmN _.. COMMEN ..- REVIEWE BY ---cL"---- _—i- _5 do Al po i W r ?.E 3a — 1I Y N