2004, 06-09 Permit App: BLD-04-04551 Residence . , L
. .
kaolesoki, BUILDING PERMIT APPLICATION WORKSHEET
S06
p City of Spokane Valley Community Development Department
e Building Division
���' '�� �.,a7 11707 E. Sprague Avenue, Suite 106
.00Iii( v Spokane Valley, WA 99206
Phone: (509) 688-0036;Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: 3 1 ? C , 1 - ' Q I
Assessor's Tax Parcel Number(s): '3524*- / t.-
Legal Description: (A)O601-1974k) p/ {S
PER T DESCRIPTION: k_ES1 oin�
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
IZ( Contractor: C L.(E F SC.Nni ITZ esAbf ❑ Architect:
Phone:q 7733 Fax:r I-q</'7/ Phone: Fax:
Address: /(QSzO E. SEG?-PfAAaT Address:
iitA2t1 DALe to 99o311
City State Zip Code City State Zip Code
WA State Contractor License #:e,LW-PSCRYleg Contact: C 1 t P Sd+vn n t.
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: ) DIMENSIONS: #OF STORIES:
13
440 x 4.i 5f°
MAIN FLOOR TO SQ. FTG: 2""FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
!b'743' $
FINISHED BASEMENT SQ. FTG: GARAGE SQ4.1p6 DEC OV. PATIO SQ. FTG:
is,OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
6,16
#OF BEDROOMS: 3 TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
l' SYSTEM? ,w
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 J
❑ BOLTING El CONCRETE ❑ 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:
•
f 2001 WSEC"Residential Compliance Form
- Prescriptive(Chapter 6)Options for all R Occupancies,Climate Zone 2 0; 1
City of Heat source: ALL •
SPOIS►ANE VALLEY BUILDING DEPARTMENT " .
11707 E.Sprauge Avenue,#106,Spokane Valley,Washington 99206-Tel 509-921-1000-Fax 509-921-1008
SITE ADDRESS:_ )g �•. f Z til PERMIT NO. DATE: 6—"7—Oli
INSTRUCTIONS
•
1) Your permit will be processed more efficiently if you provide all of the requested information. Department staff can
help you with general questions about this form_ Your building must match the selected option requirements without
-exceptions or substitutions.
2) Glazing percentage determines which option to choose. Complete the following glazing area calculation before
proceeding to the option table below.
GLAZING AREA CALCULATION:
16(0 S.F. _ 10 7 Z SF. _ 9. g %
TOTAL WINDOW AREA _ HEATED FLOOR AREA (ALL FLOORS) _ %OF GLAZING
NOTE: Use rough opening(R/O)for window area. Include all half-lite and full-lite door glazing in this
calculation-
•
CAN'T COMPLY? If none of the Prescriptive(Chapter 6)Options below are acceptable,consider systems analysis
(Chapter 4)or,Component Performance(Chapter 5)Approach.The main advantage is flexibility to juggle individual U-
factors(R-values)as long as an overall maximum value isn't exceeded. Note that the overall performance requirements•
are no less stringent than the Prescriptive requirements. Calculations may be performed by hand or, using an acceptable -
computer software program. Helpful forms and other resources can be downloaded at http://www.efiergy.wsu.edu/
buildings. .
GlazingGlazing u-Faua� wan worm int'
watt
QOPa10:Y.of /// �� Door° Ceiling Voluted Above Below ewe Floors Stab`on
Floor Vertical Overhead" U-factor Ceiling Grade Grade Below Grade
Grade .
Z L 10% 0.40 0.58 0.20 R-38 R-30 int, R-21 R-12 R-30 R-10
a El II.* 15% 0.40 058 0.20 R-38 R-30 R-5.R 21 R 12 R-30 R-10
O ;
MECHANICAL PERMIT APPLICATION
SEmmy City of Spokane Valley Community Development Department
pokane BuildingDivision
galley 11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509) 688-0037
,c FOR INSPECTIONS, CALL(509)688-0054
Project Address: 7 c� C 3 1 b � �Z' Permit Use:
Owner: Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: gS Z,ie_. E-14e)1 t., License#: Phone#:
Mailing Address:
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST = AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 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) Z X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS 2 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 _ 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 STOVE/INSERT X $10.00 =
32 WOOD STOVE-FREE STANDING X $25.00 =
METHOD OF PAYMENT: SUBTOTAL
❑CASH ❑CHECK ❑VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
PLUMBING PERMIT APPLICATION
Slaw�e City of Spokane Valley Community Development Department
Buildingetivision
galley 11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509)688-0037
FOR INSPECTIONS, CALL(509) 688-0054
Project Address: r73 r g ( 1Z444 Permit Use:
Owner: Phone (Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: ?t I'►'►-M'N S Pt.Gt,HZ 6IN(' License#: Phone#:
Mailing Address:
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 j X $6.00 =
5 SINKS LAVS/BASINS,BAR,FLOOR,
KITCHEN,LAUNDRY,UTILITY, X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CULINARY/MEAT - - -
6 DISHWASHER J X $6.00 =
7 CLOTHES WASHER j 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 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
❑ CASH 0 CHECK ❑ VISA Q MASTERCARD PROCESSING FEE $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
50 AP'
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7 w am*Ming submitted for the impels a
$$ Ing permit anti Is a true and awwu0t
of the proposal 41I known pts
IIMAImetsions,c rb • atm turas.rnd easonanM
NM been wren its:.. Its eu gyre wetlands.
bodies u :teriii; critical areae.
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ADDRESS —73 0 r- /,--,4 `�
411
1)
ZONE it t2'3.e
ROAD WIDTH 479
FRONT n2 FLANKING
CT E. OMMENTS '..:..,.'" 1 u: ' a , '
EVtEWED 8 Ly'u�,_,# -_
kit pi10 35��q . 1( 10
01 0 gl
9 3 146 6 17'