2004, 04-01 Permit App: BLD-04-03952 Residence n i ' THIS IS NOT A PERMIT
SCrr1�^,'�ne Penalties will be assessed for
r commencing work without a permit
,,000Valley NEW SINGLE FAMILY RESIDENTIAL
11707 E. Sprague Ave., Suite 106
Spokane Valley,WA 99206 Application #: BLD-04-03952
Job Address: 11918 E 12TH AVE Applied: 04/01/2004
SPOKANE WA 99212 Issued:
Description: NEW RESIDENCE W/ATTACHED GARAGE-NATURAL GAS Expires: 09/28/2004
Subdivision: Lot: Blk: Parcel No: 45214.3402 Zoning:
Owner: HOMESTEAD CONSTRUCTION INC
Applicant: HOMESTEAD CONSTRUCTION Phone: (509)892-0454
Address: 312 S FARR RD
SPOKANE, WA 99206-3666
Contractor: HOMESTEAD CONSTRUCTION INC Phone: (509)892-0454
Address: 312 S FARR RD Lic No: HOMESCI099OC
SPOKANE WA 99206-3666
General Information: Fees:
TYPE OF RESIDENTIAL PERMIT sfr PLAN CHECK FEE 408.70
VALUATION 104079 BASIC PERMIT FEE 1,021.75
BUILDING HEIGHT TO PEAK 18 WSBCC SURCHARGE 4.50
DIMENSIONS 62 X 34 TOILETS 18.00
#OF STORIES 1 TUBS 12.00
#OF BEDROOMS 2 SHOWERS 6.00
FRONT SETBACK 35 SINKS 24.00
REAR SETBACK 55 DISHWASHER 6.00
LEFT SETBACK 5+ CLOTHES WASHER 6.00
RIGHT SETBACK 5+ FLOOR DRAINS 6.00
OCCUPANCY GROUP r-3 WATER USING DEVICE 18.00
FUEL BURNING APPL<= 100,000 15.00
CONSTRUCTION TYPE 5-n
STRUCTURES ON PROPERTY 1 DRYER 10.00
CURRENTFUEL BURNING WATER HEATER 10.00
PROPERTY SIZE 83 X 115
GAS PIPING 2.00
SERVED BY SEPTIC SYSTEM no VENTILATING FANS 40.00
WELLS LOCATED ON PROPERTY no
TOILETS 3 Total Calculated: 1,607.95
TUBS 2 Deposits/Receipts: 0.00
SHOWERS(PER TRAP) 1 Total Due:
SINKS 4 1,607.95
DISHWASHER 1 CITY OF SPOKANE VALLEY �; ;.��•�. 5i'.cC�
CLOTHES WASHER 1 APPROVED FOR SUBMI .••�"" t j �i5
FLOOR DRAINS 1 EWED FOR COC�EOMPU;4 E
WATER USING DEVICE 3 Initials/ Date
SPOKANE VALLEY UILDING DIVISION
FUEL BURNING APPL<= 100,000 1
DRYER (1_, /
ray .rte
FUEL BURNING WATER HEATER 1 Building /
GAS PIPING(ea.OUTLET) 2
VENTILATING FANS 4 Planning �l,f4 iw`Li- 1
TYPE II HOOD 1 a
Public Warks_ %. •
, �,1,L-t l� '. .Q.)-i C1.C �`AL.k -(
THIS IS NOT A RECEIPT
ScTTlt 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone
pokane Spokane Valley,WA 99206 509-688-0037-Fax
.....*Valley For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT PERMIT
ADDRESS: \\G\\y \.. --'''C\-..\ USE: -
OWNER PHONE(Daytime Contact):
MAILING ADDRESS.
(street) (city/state) (ZIP)
CONTRACTOR: LICENSE#:
MAILING ADDRESS: PHONE I:
(street) (dty/state) (ZIP)
DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE •OR<100,000 \ X $15 •
2 FUEL BURNING APPLIANCE >100,000 X 519 •
3 UNLISTED APPLIANCE(ADDITIONAL FEE) •OR<400,000 X 550 •
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 •
5 USED APPLIANCE(WSEC min.AFUE rating) •or<400,000 X $50 •
6 USED APPLIANCE(WSEC min.AFUE rating) >400,000 X $100 •
7 BOILET'REFRIGERATION 1-100MBTU X $15 •
8 BOILER:REFRIGERATION 101-500MBTU X 528 •
9 BOILER:REFRIGERATION 501-1,000M BTU X 539 •
10 BOILER:REFRIGERATION 1001.1,750MBTU X . $57 •
11 BOILER:REFRIGERATION +1750M BTU X $95 •
12 CAS LOC.GAS INSERT,GAS FIREPLACE — X $10 •
13 RANGE — X $10 •
14 DRYER — X $10 •
15 FUEL BURNING WATER HEATER — *\ X $10 •
16 MISC.FUEL BURNING APPL. — X $10 •
17 GAS PIPING(ea.Outlet) — X $1 •
18 DUCT SYSTEMS — X $10 •
19 VENTILATING FANS — .DI- X $10 •
20 AIR HANDLER(DOES NOT include ducting) •OR<10,000CFM X 512 •
21 AIR HANDLER(DOES NOT Include ducting) >10,000 CFM X $19 •
22 EVAPORATIVE COOLERS — X $10 -
23 TYPE I HOOD — X S50 •
24 TYPE II HOOD — X 510
25 HEAT PUMP/AIR CONDITIONER 0.3 TON X 512 •
26 AIR CONDITIONER 3-15 TON X $20 •
27 AIR CONDITIONER 15.30 TON X 125 •
28 AIR CONDITIONER 30-50 TON X 535 •
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
MET:!OD OF PAYMENT PLUS PROCESSING FEE: $35.00
MONION :.1.-f.iit, TOTAL PRAMIT PIM O 1 i
l] C -1 ❑ CHECK ❑ •—_-!.....^i❑ .1
•
)AT: EXPIRES:
BAN: _ARD NUMBER:
ScTrl ori" "" 11707 East Sprague Avenue;Suite 106 509-688-0036-Phone
pokane Spokane Valley,WA 99206 509-688-0037-Fax
,s.1;Valley For Inspections, call 509-688-0054
Plumbing Permit Application
PROJECT PERMIT
ADDRESS: \\0\ \\ \-).....N\c„. USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS: 'I--
SS
. 1\* .. F-�<< �L`-S, S���.� �L
(street) (city/state) (ZIP)
CONTRACTOR:- LICENSE#:
MAILING ADDRESS: PHONE 0:
ct
(street) (city/state) (ZIP) •
PLUMBING FIXTURES
DESCRIPTION DETAILS $OF UNITS X COST EQUALS AMOUNT
1 TOILE IS WATER CLOSET,BIDETS X $6
•
2 URINALS X $6 -
3 TUBS , . X $6 -
4 SHOWERS(PER TRAP) BATH,STALL„ON-SITE BUILT ` X $6
5 SINKS LAVSB
ASINS,BAR,FLOOR,TIKITCHEN, -
i •
LAUNDRY,ULITY,JANITOR,PHOTO,X- X •$6
RAY,FOOD,PREP/CULINARY/MEAT
•
6 DISHWASHER X $6
7 CLOTHES WASHER , X $6 .
8 GARBAGE DISPOSAL X $6 .
9 WATER SOFTENER X $6 -
10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL X S6 _
11 FLOOR DRAINS AREA,CASE,COIL„TRENCH,CONDENSATE
\ X $6 •
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 $5 _
15 WATER USING DEVICE ICE AND/OR COFFEE
MAKER,HOSE BIB,
STEAMER,PROOFER,CARBONATOR, X $6
SWAMP COOLER
6 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND
R.P.B.P.D.FOR:VATS,TANKS,BOILERS X
7 ISPRINKLER SYS I EM X $25 .
:8 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL
HOLDING TANK X S6 -
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6
20 MISC.PLUMBING FLYTURE X $6 -
THOD OF '.VYMENT SUBTOTAL:
VISA 114'ast'd PLUS PROCESSING FEE: $35.00
:ASI CHECK j —srar
TOTAL PERMIT FEE DUE:
II: EX?IRES:
IKCARD N: MBER
'HORIZED SIGNATURE:
City of (0 a -003(o
SPOKANE VALLEY • frog 0037
PERMIT #
BUILDING PERMIT APPLICATION
Box.1 OWNER
\--\���=--� � � a� JOB LOCATION \\''>\\ ‘„
OWNER'S ADDRESS CITY : PHONE
DESCRIBE JOB \L-• • •
! HIS PROPERTY IS OWNED BY: SING E/MARRIED
'ARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME
�O��t-.,moo �.-\ PHONE
CONTRACTOR'S ADDRESS �� �� �� • CITY S �\, � Q ` c•\ L(J
CONTRACTOR'S REG.# \ � ��SL ���� EXPIRATION DATE F
(CARD MUST BE PRESENTED AND COPIED OR VEF IFIED)
BOX 3 . ONTACT PERSON OF PROJECT •
�� � , � `�•..-��b- PHONE •
_ ADDRESS CITY ZIP
BOX 4 SEWER AVAILABILITY ,
C-�--� WATER AVAILABILITY ,.�
BOX 5 ESTIMATED PROJECT COST$ +� � � EXISTING BLDG.VALUATION$ - M
BOX 6 PROPERTY TAX ACCOUNT NUMBER -' -�-----
LEGAL DESCRIPTION °y
(li= NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
• C
• CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR /\�,,K 2ND FLOOR / •
-lam
.•ZD FLOOR / OTHER ' / BASEMENT FINISHED /
);S\SEMENT UNFINISHED / \ 3"J DECK S / `%,,O GARAGE /
CA PORT / TOTAL / HEIGHT TO PEAK OF BUILDING \\' FT. .
30X 8 -�--------
( ) SINGLE FAMILY (J) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) . ( ) EXISTING STRUCTURE
( ). COMMERCIAL/ INDUSTRIAL TOTAL AREA OF PROPERTY \ c,1"Ni SQ. FT.
) TENANT IMPROVEMENT • IMPERVIOUS SURFACE
_ .,.�� SQ. F?. •
30>. 9 .UMBING FIXTURES (Including rough-ins) • MECHANICAL APPLIANCES
PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES,
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS,WATER HEATERS, CONVERSION BURNERS,
LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL i
OX 10 Water Service meter size(if known) '- -�---
Also see BOX 4
OX 11 Septic Tank-Not generally allowed in the City of Spokane Valley. For special circumstances contact r
Your sewer purveyor and the Health District (See BOX 4)
OX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public
Works Department.
JERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRIEIE AND
ORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
30VE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
N ER ',GENT �--- DATE -6 •'},.`1c � '�c (OVER)
f .�
I 1,ereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card:
V Mastercard
---- ---- Expiration Date
P:int the name of the Holder
Signature
OFFICE USE ONLY-PLEASE DO NOT WRITE BELOW THIS LINE
ZCNE SETBlACKS: FRONT SIDE
REAR_ . HEIGHT LIMIT
PL NNING DEPARTMENT APPROVAL
DISAPPROVAL DATE
REMARKS
SEPA: EXEMPT NOT EXEMPT
FIF'H DEPARTMEN APPROVAL DISAPPROVAL
• DATE
REMARKS •
• F
PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL
DATE
•
---.-
TYF OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT
• NEW COMMERCIAL COMM.ALT/ADD NEW MULTIFAMILY NO. UNITS
MULTIFAMILY ADD/ALT
TENANT IMP. ROOF OTHER
OCCUPANCY TYPE OF CONSTRUCTION
STORIES
,f BUILDING SQ. FT. @ _
BUILDING SQ. FT. @ • =
BUILDING SQ. FT. @ —
BUILDING SQ. FT. • @
TOTAL SQ. FT. TOTAL VALUATION.
BUIL ING PERMIT Np. • PLAN.CHECK FEE REC'D RECEIPT NUMBER
:i
PERMIT FEE •PLAN CHECK FEE PLUMBING FEE MECH. FEE
TOTAL FEES WSBCC SURCHARGE • ENERGY SURCHARGE •
OTHER CHARGES AMOUNT DUE
BUILT NG DEPARTM1NT APPROVAL • •BY
DATE .
ASSIGNED ADDRESS •
Ci 1 •
ADDRESS •__ -SWALE J-1
ZONE '
ROAD WID' , a•
FRONT ✓ _FLANKINt3
COMMENTS—�--�_ ----'T TYPE B ORYWELL
REVIEWED BY / TYPE a METAL
FRAME AND GRATE <_
RIM EL = 2056.00
STA 13+20, RT 32' 12TH AVENUE
— (1).SIDEWALK INLET
'- STRUCTURES
----.-••• . -- , . ti., W/ 4' OPENINGS
In r � „
. r
SIDEWALK `
87.45' ` I
1
10' UTILITYSEMENT I N
5.0' TYP. 1 `s'
c,'DRAINAGE
EASEMENT I 16 6
30' BUILDING (SETBACK _I• 1
"208" SWALE
BOTT EL = 2055.50
BOTT AREA = 352 S.F.
of
0 u7
O O1
C
O
O
Z
LP
1 87.10
— — — — J This is being submitted for the purpose of
83.60' obtaini building permit and is a true and correct
leprose la on of the proposal. AN known property
bites/dimensions,curb lines,structures and MI Manta
have been identified. Also indicated are wetlands,
S,
bodies of water, teep slopes or at d critical ands.
Signed: N
Date:
2' I 3' 22' 3.5' I 5'
-0.50' -1.0'
ro
. „1.1 G
1l ► -J2 g�� 9+�Z
7
SWALE SECTION J-1 ) o
G NTS .{�
0 15 30 60 0 \1.�C\� \�'�! �y� ��
I _ _
VALLEY PINES SUBDIVISION � %NAL E� � � o
1 inch = 30 ft. — EXPIRES 12/15/10
LOT 2BLOCK 2d
z
HAHN ENGINEERING N. 8623 SUITE B DIVISION SPOKANE, WA. 99208
0
011"\Iik Call 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
,„"Valley DEPARTMENT OF PUBLIC WORKS
Anticipated start date 4-15-2004 Permit# 04-191 Account#
ROW CONSTRUCTION PERMIT
Location of property 11918 E. 12th Ave.
(Address/Parcel#, if available)
Applicant Name Homestead Construction Fax
Address 312 S. Farr Rd. Spokane Valley,Wa. 99206 Phone 509-892-0454
Contractor's Name
Address Phone
Contractor's Reg.# HOMESCI099OC Expires
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
ElSewer Connection ■ Driveway
ElCurb &Gutter Gas Installation/Repair
ri Cable/Conduit/Pole ri Sidewalk Repair/Construction
❑ Water Installation/Repair El Other
riPavement Cut Dimensions
Bond/insurance certification must be on file with the City. Bond#_____
SPECIAL CONDITIONS: Construct driveway approach per Spokane County Standards as
adopted by the City of Spokane Valley.
See attached Provisions
Permittee Signature Approved i Date 474
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card# Expiration Date
Name of Holder Signature
Fees Paid$ 25.00 25.00 Date !nit
(Application) (Inspection)
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 not valid until One-Call Notification Ticket#entered here
PERMIT MUST BE KEPT ON SITE
v�