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2003, 06-18 Permit App: BD03-610 Residence
, Egg--©(0 3 Cityof Fix b ff 00 37 SPOKANE VALLEY / PERMIT # ,1)o,j -t, to BUILDING PERMIT APPLICATION Box 1 OWNER MA-R% A-Jt S JOB LOCATION 7 30 Z E /2 t--.1 OWNER'S ADDRESS/9t* Fr/-cd-7Q (GI' ' GniCITY �l�t c'/'(o PHONE DESCRIBE JOB /tie") Afvu/zv_ THIS PROPERTY IS OWNED BY: SIN ( E/MARRIEI PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME /4_944f v%wit/-vt PHONE CONTRACTOR'S ADDRESS CITY CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT //-r2k f)kns PHONE 7/0 7/c 3 ADDRESS n CITY ZIP BOX 4 SEWER AVAILABILITY Y Pc-ib tr i7.0 WATER AVAILABILITY t.- BOX 5 ESTIMATED PROJECT COST$ EXISTING BLDG. VALUATION $ BOX 6 PROPERTY TAX ACCOUNT NUMBER '57`f(7. /6//{ LEGAL DESCRIPTION �� / i c< /-f 4/rx I 2,c) IAICC .G+�-w J �L (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR 09.7 / 2ND FLOOR /—. 3RD FLOOR----7— OTHER / BASEMENT FINISHED 2-51° / BASEMENT UNFINISHED / DECK / GARAGE—64/ CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING FT. BOX 8 ( t' SINGLE FAMILY ( W CONSTRUCTION ( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA • • ': ' ' " SQ. FT. ( ) TENANT IMPROVEMENT V ' RVIOUS SURFACE- SQ. F . 7 BOX 9 PLUMBING FIXTURES(Including rough-ins) PEC PLIANCES PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL 'PLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS,WATER HEATERS GIONVISSI 1 URNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET A ,� ,�„ BOX 10 Water Service meter size(if known) 3w`� Al „ r- BO r - --- A\ BOX 11 Septic Tank-Not generally allowed in the City of Spokane Vail-''1�'r spec' I ir.J its contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PE M TH'/, ORK FOR WHICH THE APPLICATION IS MADE. OWNER/AGENT /' DATE 6/(54 (OVER) G I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercard Expiration Date Print the name of the Holder Signature DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES. OFFICE USE ONLY-PLEASE DO NOT WRITE BELOW THIS LINE ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE TYPE 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 BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ TOTAL SQ. FT. TOTAL VALUATION BUILDING PERMIT NO. PLAN CHECK FEE REC'D RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY DATE ASSIGNED ADDRESS Received �Y I 01 1111.1111111\114111816. 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone 1-��pOiie Spokane Valley,WA 99206 509-688-0037-Fax ,0, 0Valley. For Inspections, call 509-688-0054 -Mechanical Permit Application PROJECT 7 c 2 iV (2-f-'4 PERMIT ADDRESS: USE: AJ ) /j PVP Ni OWNER 444416. b vii PHONE(Daytime Contact): 4,7,2.,_.J$-7 MAILING ADDRESS: �� /90027 - ,„ , �.f.(/ ") 51 nc 9>i6 (street) (city/stake) (ZIP) CONTRACTOR: U C.VA/ LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (ZIP) DESCRIPTION OF WORK 8 OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<100,000 I X $15 = , 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 $50 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 - X $10 ✓ 13 RANGE -- X $10 / 14 DRYER - I X $10 /E) V. 15 FUEL BURNING WATER HEATER - t X $10 - /v f 16 MISC FUEL BURNING APPL. - X $10 .. / 17 GAS PIPING(ea.Outlet) - X $1 - o�18 DUCT SYSTEMS - X $10 19 VENTILATING FANS - 3' X $10 - /O 20 AIR HANDLER(DOES NOT include 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!HOOD - X $50 - 24 TYPE II HOOD - f X $10 - J 25 HEAT PUMP/AIR CONDITIONER 0-3 TON 1 X $12 - / 2.. 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 LPC STORAGE TANK - X $10 31 WOOD OR PELLET STOVE/INSERT - X $10 32 WOOD STOVE-FREE STANDING - X $25 SUBTOTAL: 69_CO METHOD OF PAYMENT PLUS PROCESSING FEE: '- — MOM i. TOTAL PERMIT FEE DUE: ❑ CASH ❑ CHECK ❑ rani ❑ L - •-. `" DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Sarra cx�� �rr*. 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone p0.kane Spokane Valley,WA 99206 509-688-0037-Fax 1alleY For Inspections, call 509-688-0054 Plumbing Permit Application PROJECT PERMIT ADDRESS: 7 '0 2 11 4.1 PERMIT Ny j 0144( OWNER: _ 7 ' �-� b A'CJ i( PHONE(Daytime Contact): 6 �z _ 5 5--j MAILING ADDRESS: j /J 5ye LVA y y 0 a (street) (city/state) (ZIP) CONTRACTOR: U W�l> LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (ZIP) • PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS ,Z X $6 - 2 URINALS # X $6 - 3 TUBS I X $6 - (p 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6 t Q 5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 = f ' RAY,FOOD,PREP/CULINARY/MEAT "( 6 DISHWASHER / X $6 - 4 7 CLOTHES WASHER / X $6 - G. 8 GARBAGE DISPOSAL / X $6 Le 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 I X $6 - 12 FOUNTAINS,DRINKING X $6 - C_.(� 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, 3 X $6 . - IV SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR:VATS,TANKS,BOILERS X 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - fETHOD OF PAYMENT SUBTOTAL: (1 ((13 ] CASH ❑ CHECK ❑ PLUS PROCESSING FEE — $ ❑ ._._ TOTAL PERMIT FEE DUE: 'ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: Call 24 hours before inspection required Phone 509.688-0036 Fax 509.688-0037 Sriokane .000Valley DEPARTMENT OF PUBLIC WORKS Anticipated 4r/05 p d start date � Permit # PW APPROACH PERMIT APPLICATION _ Location of property 7 3o2 �' /Z 3 5-z Y Y- /61K (Address/Parcel #, if available) Applicant Name 44444- bAtoa Address /50/17 Ar-c4 e lea Phone 2 ,/_5 - 70 Contractor's Name O0✓4/44 Address Phone Contractor's Reg# Expires PROJECT DESCRIPTION (Provide site sketch) Residential Driveway Commercial/Industrial Driveway Existing Curb & Gutter Rural Road Section Culvert Installation Sidewalk Repair/Construction nOther conditions See construction requirements and details on reverse. Bond/insurance certification must be on file with the City. SPECIAL CONDITIONS: • PERMIT FEE $ Ins•ection Fee$ 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$ 5 _�2VJ Date e 71014(3!nit a r7 302 2 g. 1 T Ni 12-288 N■■■■■■ ■■■■■■■■■■NN■■ 1111__ ■ .■■■■''■1�■E■";■■■■NM■. ■■.■■■■■.■■N■■■■■■■.■■■■■■■■■■ R': ■m■■li!:z:.iii■■.■■■N ■_ ■.■■■■■■■.■■■■■•.■�f■■■■■■■. ■■ ■ .■■■■7!ZZ}�1I/�Rruu.. ■■■■■■■■■■N■MUMPIE■■SM■■■■!E■■E■M■ ■■■.■■cs ARMWMANi'! ■■■■■■■■■...m�i.■■■■■ ■■. ■ ■��,n ■ .1111 ■ ::::1:::1 111111:1 111111!! 1AA 11:::�1:1 :11 11.11.■ ■■ ■■■�■ ■L►7■■ 'Iii u... ■.■■ !■ ■.■ 1::: :'C■!�:•::• •: ■:I N : 91111111111111111111 ■■■■ ■11..11■■ : 11010.LM: 1 -01101-ME ■ . . ■ ■N1 : :. .... _ :1 ■. N !■. 1111111111111111111/ !! k' L ! !. 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