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2004, 06-23 Permit App: BLD-04-04693 Residence BUILDING PERMIT APPLICATION WORKSHEET CISOlde\11111% City of Spokane Valley Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 4 0100 �� Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 REST ED SITE INFORMATION p Street Address: Lir-in Lir-inE t h A v L oKA r�L-' v 4 L t.E 1 e-r%-t WA. 0) 5 'a l'�. Assessor's Tax Parcel Number(s): Legal Description: L.30 c C) p ^e-f 2.i , c .-R PERMIT DESCRIPTION: s .31e A C -E L4-1/ J-rr A -C1,1 kr 11 &Ail A4 K: Xr Ft Building Permit ❑ Change in Use 0 Grading 0 Manufactured Home P ❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION (me, cd .A 3( - 6 7) v- © Owner: G Fw i C I+R 1ST(Ni ST IC Ke-(nke,liev" El Applicant: SCS viite c . . ccs 1 ev' Phone: 534- 3 I t& Fax: Phone: Fax: Address: (,. 4 S. m N r V ev r,cpk s r Address: r it.LNt:: lArA c 9.22 3 City State Zip Code City State Zip Code Contractor: 'o\,,,N��— ❑ Architect: ot, N Le-A-- Phone: Fax: Phone: Fax: Address: Address: City State Zip Cede City State Zip Code WA State Contractor License#: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK 15 `-i DIMENSIONS: LI 6` y (03 , #OF STORIES: ) MAIN FLOOR TO SQ. FTG: 2N°FLOOR SQ. FTG: �. UNFIN BASEMENT SO. FTG: Lt00 SQtX N/A N/4 FINISHED BASEMENT 1. FTG: GARAGE SQ. FTG: ` 0 V) .'f �C oV. PATIO SQ. FTG: , -,cj�' OCCUPANCY GROUP: CONSTRUCTION TYPE: v o G 6/FRivi HEAT SOURCE: CxAs i-1 o r WR Tt, CL J Ek) fPriptAivi HL T 511-CrVi *OF BEDROOMS: ' TOTAL HABITABLE SPACE: 00 yzr IMPERVIOUS SURFACE AREA: COS OF PROJECT: 150 -O 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? t�W t--'li—0 a`�434'• 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 rip SPECIAL INSPECTIONS ___________-___ (-(AP c,TI geo-recHS VMiT �iTE-TKEire_ OPlrJtoti - LDionrr rJe-e1) A-1JI. (l BOLTING ❑ CONCRETE 0 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 t 0 . . Tice_ yvt rY Signature Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard RI VISA 0 Other Bankcard#: _ - .... Expires: VIN#: Authorized Signature; -- -- . PLUMBING PERMIT APPLICATION . 0,44%.11, poifiane City at Spokane Valley Community development Department BuildingDivision ValleY 91707 E. Sprague Avenue, Suite 106 41 1010 Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS,CALL.(509) 688-0054 Project Address: Permit Use: .-- Owner: Phone (Daytime Contact): _ Mailing Address: City State Zip Code Contractor: _._ License#: Phone#: -. Mailing Address: City _ State Zip Cade F.OF © TOTAL DESCRIPTION OF WORK UNITS © COST AMOUNT r TOILETS _ WATER CLOSET,BIDETS - $6.00 - ili URINALS 56.00 e TUBS C 1 III $6.00 (o. G J IN SHOWERS -ER TRAP BATH.STALL,ON-SITE BUILT I IN $6.00 (D-(,U SINKSI LAVSIBASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, 00 LI%. JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT1.11111r156.00 �, , UU DISHWASHER © $8.00 (o . O D 11 CLOTHES WASHER 111121111111 56 0011111111111111 GARBAGE DISPOSAL -_ © L.,WATER SOFTENER ;8.00 El ELECTRIC HOT WATER TANK NOTE: IF GAS SEE MECHANICAL 111 $6.00 = II FLOOR DRAINS AREA,CASE,COIL,TRENCH, 111 $6.00 () U O CONDENSATE . In II $800 ROOF DliAIfi1S/OVERFLOW DRAINS ® FOUNTAINS DRINKING $6.00 WATER PIPING/DRAIN-IN WASTEII MECHANICAL 111 se.o0 = II �� $6.00 VENT, PLUMBING,REVERSAL -_- -_REPAIR REVERSALS SEWAGE EJECTOR GRINDER,SUMP PUMP $6.00 WATER USING DEVICEI ICE AN/OR COFFEE MAKER HOSE BIB,STEAMER,PROOFER, '�736.00 • . CARBONATOR.SWAMP COOLER CROSS CONNECTION DEVICEI VACUUM BREAKER CHECK VALVE,AND R.PB.PD.FOR: $6•00 VATS,TANKS,BOILERS Ill 111 INTERCEPTORS GREASE TRAP,SAND TRAP, $6.00 CHEMICAL HOLDING TANK IN MEDICAL GAS(per outlet) NITROUS,OXYGEN 111 9e.00 111 20 MISCELLANEOUS PLUMBING FIXTURE X _ 56.W 1111= all METHOD OF PAYMENT: SUBTOTAL CI CASH © CHECK 0 VISA 0 MASTERCARD PROCESSING FEE 51506 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: -- AUTHORIZED SIGNATURE: -. . MECHANICAL PERMIT APPLICATION $oliant' "\i"" City of Spokane Valley Community Development Department BuildingDivision 11707 E Sprague Avenue, Suite 106 40,Valley Spokane Valley, WA 99206 Phone: (509)668-0036,;Fax: (509)688-0037 9k12.. FOR INSPECTIONS, CALL(509) 688-0054 Project Address: /..1_1.E.9 I _13.2.-k AvL I‘tprlt,J4L ,,e,'i) Permit Use: _ Owner: i,I-1 A) -4- C NRI STI,J V S T I c. f.c Egn Phone(Daytime Contact): 2 2 0-Gyco 7 Mailing Address: _ata-`4 s. TY Uernor CT. oK g92.z3 Contractor: 0 c,- N Lam- en__ City State Zip Code u��0 rc License*. Phone#: Mailing Address: - "-" C' State Zip Code DESCRIPTION OF WORK IIIIIIIIIIIIIIIII U#NITOFS X COST AMOUTOTALNT III FUEL BURNING APPLIANCE Equal to or less than 100 000 X $15.00 © FUEL BURNING APPLIANCE Mora than 100,000 X $19.00 ..► © UNLISTED APPLIANCE Additional Fee .1181 to or teas than 400.000 X $50.00 ril 1 4 UNLISTED APPLIANCE JAdd1IIonal Fee More than 400 000mug $l fl0.00 im USED APPLIANCE(WSEC min.AFUE 5 rats - ~•um to or less than 400,000 850.00 USED APPLIANCE(WSEC min.AFUE 6 ratio! - More than 400 000 PI $700.00 II 7 BOILER/REFRIGERATION 1-100M BTU , $15.00 1 s BOILERJREFRIGERATION 101-SOON BTU © $28.00 9 BOILER/REFRIGERATION 501.1,000M BTU IIIE $39.00 111111.111111 10 BOILER/REFRIGERATION 1,001-1,750M BTU $57.00 11 BOILER/REFRIGERATION More than 1,750M BTU_ III $95.00 in 12 GAS LOG,GAS INSERT.GAS FIREPLACE © $10.00 IN� '� • 13 RANGE MIN $10.00 NMI 14 DRYER $10.00 1S FUEL BURNING WATER HEATER a $10.00 111111111111 16 MISC,FUEL BURNING APPLIANCE 1114-411. © $10.00 eamen 17 PRMEFNMIIIIIIIIINII 11N 1$ DUCT SYSTEMS in 5t0A0 in 10 VENTILATING FANS 3 in $10,00 ■em= 20 AIR HANDLER 1"ES NOT include ductin. E.uat t0 or less than 10,000 UM nell1111 $12.00 ■ 21 AIR HANDLER DOES NOT include dueling) Greater than 10,000 CFM ig- $16.0011 22 EVAPORATIVE COOLERS NM $10.00 23 TYPE I HOOD 11 $50.00 1111111111111111 24 TYPE it HOOD Milli $10.00 B 25 HEAT PUMP/AIR CONDITIONER 0-3 TON iniri $12.00 E 26 AIR CONDITIONER 3-15 TON B $20.00 111111111111 27 AIR CONDITIONER 15-30 TON NI© 525,00 IIIIIIIIIIII 28 AIR COMMONER 30-50 TON ill $35.00 11 2e AIR CONDmONER More than 50 TON 111111111© 550,00 30 LPG STORAGE TANK B $10.00 mem 31 WOOD OR PELLET STOVE/INSERT B $10.00 rmonems 32 WOOD STOVE_FREE STANDING ,1 $25.00 EIIIIIIIIIIIII METHOD OF PAYMENT: SUBTOTAL 1111.1111111111 DATE: ©CASH 0 CHECK 0 VISA 0 MC PROCESSING FEE 1 $35.00 CARD#: _ EXPIRES: - TOTAL PERMIT FEE DUE: I .UTHORIZED SIGNATURE: ,y. Inspections performed 10 days after r. scheduled completion to schedule call (509)688-0195 or Fax(509)688-0037. Any re- °` = inspection will incur an additional $25.00 charge. , 11707 E Sprague Ave,Suite 106 Spokane Valley,WA 99206 • ROW Construction Permit Permit# ROW 04-427 Issue Date 6/23/2004 Account# Completion Date Issued by Kcummings Construction Utility Location of Property Project Description 4717 E 13TH AVE driveway Comments Contractor Name CRN # Individual Name INDIVIDUAL STICKELMEYER, DOU Address Contractor Phone# Bond Origination Date Bond $ $0.00 Permit Fee Inspection Fee Total Fees Collected $25.00 $25. 0 $ 50 /� Permittee Signature Approved Date 6Q 1:hh'J (1—1 I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Credit Card# Expiration Date Name of Holder Signature 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.(112 hour) minimum. Permittee signature constitutes an agreement to these terms and provisions. Work completed satisfactorily(signed) Date PERMIT MUST BE KEPT ON SITE MOMPOIMAR.I.MIONWPOMMOSIO 1 4+ 79 Tir , . PLANNING OPT.APPROVED B -__ __Z..... , . (q)/06 (0-1, Q. Fr Lor DATE: (e/023/6 .474 t7. 4117 ea: it Aua , . sPoifrA)a-p.44.1.01 6/rtfikv4 092/1.-- , MO 1 . . Q0 0 _ - Q to800 sarr '(::7 GAIZAMI: , . I k 2.4‘06.0 So.Fr. I 4 . P A , s o Odoc, &r6eie A /A tn .., .,. ../ / / %,- -- - 7 1* .// / -7 • // / / ' •'- / / / / /'/ sO .•/././ ti ii t ca.v,a3 teasoltAct4,+- 7...,,..&....._110.,-. . eCUC., t elig4SPPE .5;rieuzei.mote4e-p—. ›, < FAISTInla- 15. EASeriser W1,4.- .5.3q-314, cat- /30,. bqc .7 ,56 .1- $. plur- teativeA) a filnleve; 1444- qqar42