2004, 06-28 Permit App: BLD-04-04794 Residence .clr SPO
BUILDING PERMIT APPLICATION WORKSHEET
lrne City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
40000*Va1l Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
JUN 2 8 2004
D
D -cin-Ll T FORMATION
Street Address: 472-3 4:1,./ /3 X11 ,i>___,
Assessor's Tax Parcel Number(s):
Legal Description: D '1' Li-n
PERMIT DESCRIPTION:
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
DI Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: -41re-� — ❑ Applicant: �,t 1
Phone: � •�—j�l 3 rax: Xt _/g!3 Phone: Fax:
Address: P4 -30 >92._ Address:
fife QQ2 3
City State Zip Code City State Zip Code
❑ Contractor: i.„6"?d,ez.eiC .,6, ❑ Architect: ,16, 1 7,7z ,
Phone: Fax: t` '�
Phone://5 —ZS" Fax
Address: `�{�O-- -'
Adgf ess: ;,.„mA ,/ r. .
City State = gi 2/(? `l/t7 q9 ,
Zip Code city State Zip Code
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: ‘12 X�Z #OF STORIES: /
MAIN FLOOR TO SQ. FTG: z7� 2”)FLOOR SQ. FIG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
/2..S `��� 7J"`ie.'
OCCUPANCY GROUP: 0 CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
zs z4
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
SYSTEM? 5Kttiti-yam
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
0 BOLTING ❑ 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 0 Check ❑ Mastercard 0 VISA 0 Other
Bankcard#: Expires: VIN#:
Authorized Signature:
"\II4kt
�� PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
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: 1723 i- /314' GGA Permit Use:
Owner: 4 Z,d-U„ , 6-Y1/a- Spe,,,___.- Phone (Daytime Contact): ç —/d9 / 3
Mailing Address: /) &X, 792-- -4 / /fes //ffq 992 3
City State Zip Code
Contractor. ��! License#: Phone#:
Mailing Address:
City State Zip Code
#OF I TOTAL
DESCRIPTION OF WORK UNITS I X COST ■ AMOUNT
1 TOILETS WATER CLOSET,BIDETS "5 X $8.00 =
2 URINALS X $6.00 =
3 TUBS 3 X $8.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X 58.00 =
5 SINKS LAVSBASINS,BAR,FLOOR,
/
KITCHEN,LAUNDRY,UTILITY, X $6.00 =
JANITOR,PHOTO,X-RAY,FOOD,
—
PREP/CULINARY/MEAT
6 DISHWASHER / X $8.00 =
7 CLOTHES WASHER 2_ X $6.00 =
8 GARBAGE DISPOSAL / X 58.00 =
9 WATER SOFTENER C X $8.00 =
`
10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL C X $8.00 =
11 FLOOR DRAINS AREA,CASE,COIL TRENCH, I X $8.00 =
CONDENSATE
12 ROOF DRAINS/OVERFLOW DRAINS , Q X 58.00 =
13 FOUNTAINS,DRINKING X $8.00 =
14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 =
VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 19 -
15 SEWAGE EJECTOR GRINDER,SUMP PUMP / X $8.00 =
18 WATER USING DEVICE ICE AN/OR COFFEE MAKER,
HOSE BIB,STEAMER,PROOFER, 5 X $8.00 =
CARBONATOR,SWAMP COOLER rrrr
17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK
VALVE,AND R.P.B.P.D.FOR: n X $8.00 =
VATS,TANKS,BOILERS F-'
18 INTERCEPTORS GREASE TRAP,SAND TRAP, D X $6.00 =
CHEMICAL HOLDING TANK 0
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE X $8.00 =
METHOD OF PAYMENT: SUBTOTAL
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD PROCESSING FEE $35.00
DATE EXPIRES: TOTAL PERMIT FEE DUE: ,
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
,\INek
SpUq��e MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
• ' BuildingDivision
Sprague Avenue, Suite 106
4,
Valley f 1707 E.Spokane Valley, WA 99206
Phone: (509)688-0036;Fax: (509) 688-0037
FOR INSPECTIONS, CALL(509)688-0054
Project Add ess: 271 2-3 L' /; '-- Permit Use:
Owner: ('- ^ , A. Phone(Da ime Contact): c ,, ,e--0 I;
Mailing Address: /i - M7 7 ,1/ //fe ,i Gj Z3
/ iz `�/ GitY State Zip Code
Contractor: 4d'6L il ._- Re
�.�� 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 Morethan 100,000 X $19.00 =
3 UNLISTED APPLIANCE(Additional Fee) Equal to or less than 400,000 r 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 mint AFUE
8 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
1,001-t,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 X $10.00 =
18 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) 2 X� $1.00 =
18 DUCT SYSTEMS / X $10.00 =
19 VENTILATING FANS / X $10.00 =
20 AIR HANDLER(DOES NOT include ducting) Equal to or less than 10,000 CFM 6 , 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 , 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..4 $35.00 =
29 AIR CONDITIONER More than 50 TON X 580.00 =
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
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE
$35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
62'-0'
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;‘ _ _ __ ___ __"/F'AVED DRIVEWAY m,_O.
I 6- SITE PLAN (119.23' -r--
— Scale: 1"=20'-0" ® {1 f5.z5') �`..�� i
LEGAL DESCRIPTION: NORrN PROPERTY LINES EXIST. CURB CUT
v
A CERTAIN PARCEL OF LAND BEING A PORTION OF LOT 12. BLOCK 3 AND A PORTION OF VACATED
WILLAMETTE STREET AS PER PLAT RECORDED IN VOWME II OF PLATS AT PAGE 16, RECORDS OF
SPOKANE COUNTY, WASHINGTON BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF LOT 10, BLOCK 3; THENCE ALONG THE NORTH LINE OF
LOTS 10, 11 AND 12, BLOCK 3 SOUTH 89'29'57' EAST A DISTANCE OF 130.10 FEET TO THE TRUE PROJECT ADDRESS: 4123 EAST 13TH AVE.
PONY OF BEGINNING; THENCE CONTINUING ALONG THE NORTH LINE OF SAID LOT 12 SOUTH 89'29'57" SPOKANE, WA
EAST A DISTANCE OF 19.60 FEET TO 'THE WEST RIGHT OF WAY LINE OF VACATED WILLAMETTE STREET 14,240 S.F.
PER SPOKANE COUNTY COMMISSIONERS RESOLUTION NO. 1--0652; THENCE ALONG SAID VACATED WEST LOT AREA:
RIGHT OF WAY NORTH 00'04'25' WEST A DISTANCE OF 6.00 FEET; THENCE SOUTH 89'29'57" EAST A
DISTANCE OF 60.00 FEET TO THE EAST LINE OF SAID VACATED RIGHT OF WAY; THENCE ALONG SAID % LOT COVERAGE: 9%
EAST LINE SOUTH 00'04'25" EAST A DISTANCE OF 135.78 FEET 10 THE SOLRH LINE OF BLOCK 2;
THENCE ALONG THE SOUTH LINE OF BLOCK 2 EXTENDED WEST AND THE SOUTH LINE OF BLOCK 3 BUILDING HEIGHT: APPROX. 22' (AVG. NT, g PERIMETE'
NORTH 89'28'57' WEST A DISTANCE OF 85.59 FEET TO THE POINT OF CURVATURE OF A 50,00 FOOT
RADIUS NON—TANGENT CURVE CONCAVE TO THE SOUTHWEST HAVING A RADIAL BEARING OF SOUTH AREA (Less Ge)
53'3$51 WEST; THENCE NORTHWESTERLY ALONG SAID CURVE THROUGH A CENTRAL ANGLE OF 19'44'55" : ara 9 MAIN LEVEL: 1,216 S.F.
AN ARC DISTANCE OF 17.23 FEET; THENCE NORTH 08'47'00" EAST A DISTANCE OF 119.23 FEET TO THE UNFINISHED BSMT: 1,252 S.F.
TRUE PONT OF BEGINNING, TOTAL 2,528 S.F.
GARAGE: 450 S.F.