2004, 02-03 Permit App: BLD-04-03499 Residence .
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PERMIT APPLICATION ORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIV/S/ON
11707 East Sprague Ave Ste 906
Spokane Va//ey, WA 99206
•
Phone: 509 688-0036 Fax.- 509 688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS:
' /3
ASSESSOR'S TAX PARCEL NUMBER(S);
LEGAL DISCRIPTION; //s/ 2 /�
PERMIT DESCRIPTION:. " V/
jatiT •DING.PET. C�CHANGE.IN. .
Ca ILDING PE -CRA USE •.0 GRADDI- C I MAAI�IITFA
• -TENANT CI TIRED.HOME
LTOTIEEER
[ . .
------ ___ OWNER / APPLICANT INFORMATION
OWNER: •
-.�a�EY CONSTRUCTION --- -----____—
____J
792 , Ih� APPLICANT: ��EY CONSTRUCTION
PHONE: "CANE u�. .. Ih,
^ F2$X. PHONE: "o NE,
ADDRESS: 7°---3 �/ WA 9g
€-P, —jD 13DORESS:
CITY,STATE,ZIP
CONTRACTOR:---j'AII—CONSTRUCTI°N Ci
CITY,STATE,ZIP
PHONE:------777
HONE: •
,.0. BOX 30792 ARCHITECT:
'ANE, FAX;
ADDRESS: PHONE:
FAX:
CITY,STATE,ZIP ADDRESS;
WA ST CONTRACTOR UCENSE# CITY,STATE,ZIP
- -- -- - - CONTACT:
PERMIT/BUILDING INFORMATION
_]COST OF PROJECT:
30%SLOPES ON PROPERTY;
BUILDING HEIGHT TO PEAK; _ MAIN FLOOR SQ FT;
OCCUPANCY GROUP:.
BUILDING DIMENSIONS: 2ND FLOOR SQ FT:
__�_
--------. CONSTRUCTION TYPE:
NUMBER OF STORIES: UNPIN BASEMENT;_
STRUCTURES ON PROPERTY:
------ FINISHED BASEMENT:
NUMBER of BEDROOMS:
____ —_ CRITICAL AREAS:
FLANKING SETBACK: GARAGE:
CURRENT PROPERTY SIZE:
FRONT SETBACK: COVERED DECK:
CURRENT PROPERTY USE:
REAR SETBACK: DECK:
CURRENT SEPTIC US.E:
LEFT SETBACK: CURRENT WELL USE:
RIGHT SETBACK: IMPERVIOUS SURFACE AREA:
Scrn•Ir 11707 East Sprague Avenue,Suite 106 509-688-0036- Phone
pokane Spokane Valley,WA 99206 509-688-0037-Fax
41. Valley For Inspections, call 509-688-0054
Plumbing Permit Application
PROJECT PERMIT
ADDRESS: 4 , (c 613 USE:
OWNER:Lin os� �4J//_ ' S T- I ry PHONE(Daytime Contact): g' . 1.12....6
MAILING ADDRESS: i1�
pc /90 3o)4Z S pone- co
(street) (city/state) (ZIP)
CONTBACTO;S J r4 LICENSE II:
MAILINGPO is 47?/ PHONE I:q07',` `
VeaaclQ /vet gDR -7 7
(street) (city/state) (ZIP) •
PLUMBING FIXTURES
DESCRIPTION DETAILS t OF UNITS X COST EQUALS AMOUNT
I TOILETS WATER CLOSET,BIDETS r X $6 -
2 URINALS X $6 -
3 TUBS
X $6
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 -
5 SINKS LA VS/BASINS,BAR,FLOOR,KITCHEN, !�
LAUNDRY,UTILITY,JANITOR,PHOTO,X- j X $6
RAY,FOOD,PREP/CULINARY/MEAT
6 DISHWASHER / X $6 -
7 CLOTHES WASHER
f
X $6 -
8 GARBAGE DISPOSAL / X $6 -
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 ( 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 $6 -
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB,
STEAMER,PROOFER,CARBONATOR /7 X $6 -
SWAMP COOLER 7
16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND
$6 -
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
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 -
20 MISC.PLUMBING FIXTURE X $6 -
SUBTOTAL:
METHOD OF PAYMENT
VISI' ' zsL PLUS PROCESSING FEE: $35.00
❑ CASH ❑ CHECK 0 ZIENNI1 0 L.-. ._.:- ':
TOTAL PERMIT FEE DUE:
DATE. EXPIRES:
BANKCARD NUMBER.
AUTHORIZED SIGNATURE:
I ..
SCITYia
t 11707 East Sprague Avenue, Suite 106 509-688-0036-Phone
p0rie Spokane Valley,WA 99206 509-688-0037-Fax
.. IF Valley For Inspections, call 509-688-0054
Mechanical Permit Application
PROJECT PERMIT
r
ADDRESS: J 1 -. • USE:
OWNER ,nOcet, /•si9sr► Inc PHONE(Daytime Contact): $29 I y
MAILING ADDRESS: �-�/
Pi/3iix 30792- cpo tanz (LIQ 99?& 3
(street) (city/state)
(ZIP)
CONTRACTOR: ki)L _ Aztviz. Ly/ Gtyrm6e LICENSE#:
MAILING ADDRESS:
I PHONE 8:
(street) (city/state) (ZIP)
DESCRIPTION OF WORK I OF UNITS X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE •OR<100,000 r X $15 •
2 FUEL BURNING APPLIANCE >100,000 X $19 •
3 UNLISTED APPLIANCE(ADDITIONAL FEE) •OR<400,000 X $50 •
4 UNLISTED APPLIANCE(ADDmONAL FEE) >400,000 X 5100 •
5 USED APPLIANCE(WSEC min.AFUE rating) •or<100,000 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,CAS FIREPLACE - X 510
13 RANGE - X $10 •
14 DRYER - X 510 •
15 FUEL BURNING WATER HEATER - I X $10 •
16 MISC.FUEL BURNING APPI. - X $10 •
17 CAS PIPING(ea.Outlet) - X $1 •
18 DUCT SYSTEMS
- j X $10 •
19 VENTILATING FANS - X $10
20 AIR HANDLER(DOES NOT Indude ducting) •OR<10,000CFM 7 X $12 -
21 AIR HANDLER(DOES NOT Include dudins) >10,000 CFM X $19 •
22 EVAPORATIVE COOLERS - X $10 -
23 TYPE I HOOD - X $50 •
24 TYPE 11 HOOD - X $10 •
25 HEAT PUMP/AIR CONDITIONER 0.3 TON X $12 •
26 AIR CONDITIONER _ 3-IS TON X $20 •
27 AIR CONDITIONER 15-30 TON X $25 •
28 AIR CONDMONER 30.50 TON X $35 •
29 AIR CON DMONER X50 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:
METHOD OF PAYMENT PLUS PROCESSING FEE: $35,00
MEM
VISA ' tt,s14441
TOTAL PERMIT FEE DUE:
0 CASH 0 CHECK 0 .• . O I_ . ?`
1
DATE: EXPIRES:
BAN KCARD NUMBER:
AUTHORIZED SIGNATURE:
Proposed Plot Plan
4609 East 13th Avenue
City of Spokane Valley
County of Spokane,State of Washington
LOT 7, BLOCK 4,WOODLAND TERRACE
SCALE 1:20 I SEWER&WATER PROVIDED BY CITY OF SPOKANE
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