2002, 07-07 Permit App: BLD-03-02028 Finish Basement JUN 28 2003 09:03 FR TO 5361123 P.04/04
': My.of Spokane Valley PHONE (509)688-0036
t707 Fast Sprague Avenue, Suite 106 FAX # (509)688-0037
)okane Valley, WA 99206 •
PERMIT#
BUILDING PERMIT APPLICATION
Box 1 OWNER I • /r e I" ' JOB LOCATION_11_1112, /
OWNER'S ADDRESS /./ --- 5 ITY PHONE 9-Z�z -dye-7
DESCRIBE JOB ' / //
. 4111
THIS PROPERTY IS OWNED B :SINGLE/ RIED
PARTNERSHIP . CO .
BOX 2 CONTRACTOR'S NAME f► c�r � f 3 e `' ,_•PHONE iFf f/02 7.22
CONTRACTOR'S ADDRESS — CIT-
CONTRACTOR'S REG.# _. EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT /'(di i'� e �" PHONE d'lY- 1-2 fe9 e:7 7' -epi
ADDRESS CITY ZIP_ •
•
BDX 5 ESTIMATED PROJECT COST$ EXISTING BLDG.VALUATION$
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
•
BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR - 2ND FLOOR7cO /
•
3RD FLOOR_ / OTHER - I BASEMENT FINISHED /
BASEMENT UNFINISHED ).5 c it DECK / GARAGE I
CARPORT I TOTAL _/ HEIGHT TO PEAK OF BUILDING Fr.
BOX 8 ( . SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT.
( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE_ • SQ. FT.
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND '
;ORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE.
WNER/AGENT �\ ,DATE
hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: ,
i7isa Mastercard ,---- -----` ----- Expiration Date
Print the name of the Holder Signature_
** TOTAL PAGE.04 **
JUN 28 2003 09 02 FR TO 5361123 P.02/04
SPokane
0� w� 11707 East Sprague Avenue,Suite 1065O9-688-0036-Phone
Spokane Valley,WA 99206 509-688-0037-Fax
For Inspections, call. 509-688-0054
Plumbing Permit Application ------ - -
imuswPROJECT SPIT
ADDRESS: I,g / 9 e, j„1 _,x, USE:
IOER' k Cl t"11 1-1 , E `"0 _ PHONE(Daytime Contact): 5-3(o ' /107 e,
MAILING ADDRESS:
�1 C a A, i
(street) (ci /state) - (ZIP)
CONTRACTOR: I �f,�
() .J
LICENSEMAILING ADDRESS: +- PHONE 9:
•
• (street) (city/state) C1-19) - '
•
PLUMBING FIXTURES
DESCRIPTION DETAILS C OF UNITS I COST EQUALS AMOUNT
1 TOILETS - WATER CLOSET BIDETS X $6 -
2 URINALS X $6 W
3 TUBS X $6 . -
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BVILT X $6
5 SINKSLAVS/SASINS,BAR,FLOOR,RrrcHEN,
•
• LAUNDRY,UTILITY,JANITOR,PHOTO,X X $6 -
_ RAY,FOOD,FREP/CULINARY/M'EAT •
6 DISHWASHER X • 9.6 + •
,
7 CLOTHES WASHER X ' $6 - 4 - .0$
8 GARBAGE DISPOSAL X $6 •
9 WATER SOFT'ENNER X $6 •
10 ELECT,HOT WATER TANK NOTE:. IP GAS,SEES MECHANICAL X $6 r. /J_LJ--
11 FLOOR DRAINS ARIA,Casa,COIL,TRENCH,cONEENSATE X ' $6
12 FOUNTAINS,DRINKING • X $6
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, -
WAST E,VENT,PLUMBING. REVERSALS X S6. -
REVERSAL„ •
14 SEWAGE EJECTOR GRINDER,SUMP PUMP •X $6 •
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB, .
STEAMER.PROOFER,CARBONATOR, X $6 • -
- 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 CREASE TRAP,SAND TRAP,CHEMICALX $6
• HOLDING TANK ,
19 MEDICALGASper outlet NITROUS,OXYGEN X $6 • `
20 ,MISC.PLUMBING FIXTURE X $6 -
- -- - •
SUBTOTAL:
'OD OP PAYMENT •
1— •1?::::-4 ,. i
• -- PLUS PROCESSING FEE $35.00
;110 CHECK 0 0 _ --.-_.-.,,i
TOTAL PERMIT FEE DUE:
• EXPIRES: -
ARD NUMBER: .
)FRED SIGNATURE:
JUN 28 2003 09 02 FR TO 5361123 P.03/04
•
MECHANICAL PERMIT APPLICATION
PROJECT PERMIT
ADDRESS: USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS:
• (rest) (city/state) _ _ip)
CONTRACTOR: UCENSEi:
MAILING ADDRESS: PHONE it:
(street) (city/state) (zp) r..—
DESCRIPTION OF WORK *or my X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE :OR<100,000 X $15 •
2 FUEL BURNING APPLIANCE X100,000 X $19 7 _.
_3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR.400,000 X ' $50
4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 -
5-USED APPUANCELIIVSEC min.AFUE rating) OR<400,000 X $50 •
6 USED APPL ANCESWSEC min,AFUE Mktg) '400,000 X $100 z
7 BOILER/REFRIGERATION 1-100M BTU X $15 •
8 BOILER/REFRIGERATION 101-500M BTU -- . X $28 ll •
9 BOILER/REFRIGERATION 501-1,000M BTU ' X $39 z
10 BOILER/REFRIGERATION _ ' 1001-1,750M BTU " X $57 - ,
11R/REFRIGERATON +1750M BTU X $95 • .
12 GM LOG%GAS INSERT,GAS FIREPLACE - .. X $10 c
13 RANGE - X $10 ¢
14 DRYER - , X $10' - - o
"15 E
1 L BURNING WATER HEATER - X $10 o
16 MISCELLANEOUS FUEL BURNING APPL - X $10 =
- 17 GAS PIPING sea.Outlet) - X $1 =
16 DUCT vsTEM3 -
x $10
19 VENTILATING FANS _------:-:----1-7r-- ---'
20 AIR HANDLER(DOES NOT Include ducting) •OR<10,000CFM X $12 •
21 AIR HANDLER(DOES NOT Include duct) >10,000CFM X $19 +i
22 EVAPORATIVE COOLERS - X $10 -
23 TYPE I HOOD _ - X` $50� ig
24 TYPE II HOOD - X_ $10 +c
25 HEAT PUMP/AIR CONDITIONER 0-3 TON _- X ,$12 la
26 AIR CONDmONER 3-15 TON , x $20 ''
27 AIR CONDITIONER 15-30 TON X $25 a
28 AIR CONDITIONER 30-50 TON X $35 -
29 AIR CONDITIONER _ .+50TON X - $80 '
30 LPG STORAGE TANK - • X $10 -
r31 WOOD OR PELLET STOVE/INSERT - - r X $10 •
32 WooD STOVE-FREE STANDING - X $25'
, SUBTOTAL
❑ CASH 0 CHECK PLUS PROCESSING
Paners $35.00
OP C
,
TOTAL PERMIT FEE
• DUE
DATE: ' _ EXPIRES: --
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: