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2004, 10-15 Permit App: BLD-04-07928 Residence W111O\( /Nan'am 1011".\41111111% 61)ma BUILDING PERMIT APPLICATION WORKSHEET City of Spokane Valley Community Development Department Building Division ValleY40010* 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036;Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: '/?J c E /`i Assessor's Tax Parcel Number(s): Legal Description: C`f 1-D I S -�- W o i � 7 '�l� I Z /t' t iC4.47i 4Q f '222' PERMIT DESCRIPTION: Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home 0 Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other OWNER/APPLICANT INFORMATION X Owner: LM y C r fi inc, ❑ Applicant: l Phone: 1e13 Fax: c iUo Phone: Fax: Address: Address: City State Zip Code City State Zip Code ,❑' Contractor: Lam- LJ �� `Mc, ❑ Architect: Phone: /Oi 3 ax: 443 jC3 Phone: Fax: Address: Address: City State Zip Code City State Zip Code WA State Contractor License #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS.�x #OF STORIES: r-� 4-t G, MAIN FL OR T SQ. FTG: 2""FLOOR SQ. FTG:3 ' UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: 4Y )N2. DECK/COV. Pl TOSQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: A�a #OF BEDROOMS: , TOTAL HABITABLE3 ACE: IMPERVI U ACE AREA: COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER 011RiSterSITE SEPTIC SYSTEM? P vveY • 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 El BOLTING ❑ CONCRETE ❑ REINFORCEMENT El 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 0 Mastercard ❑ .VISA ❑ Other Bankcard#: Expires: VIN#: Authorized Signature: ' MECHANICAL PERMIT APPLICATION City of Spokane Valley Community Development Department Sioniee\INIk BuildingDivision Valle 11707 E. Sprague Avenue, Suite1106 40, Spokane Valley, WAA99206 Phone: (509)688-0036;Fax: (509)688-0037 q7O e- (fir 4-ti FOR INSPECTIONS, CALL(509)688-0054 Project Address Permit Use: Owner: ��C� k SoC. Phone (Daytime Contact): I1;'it�j Mailing Address: .0 , 'ex'X • '7 VW.t_n'� ate Zip C de Contractor: l i„ ` r1 c_ ice a#: Phone#: ‘5.e) --[ 10/3 MailingAddress: ,0 . K ? -ne i 2. Kr e �?'22 State Zip Code #OF TOTAL DESCRIPTION OF WORK UNITSi X COST = AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 - 1 _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 More than 400,000 X $100.00 = 6 rating) 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 = X $10.00 = 13 RANGE - 14 DRYERX $10.00 = 15 FUEL BURNING WATER HEATER ' X $10.00 = 16 MISC.FUEL BURNING APPLIANCE X _ $10.00 = 17 GAS PIPING(each outlet) X $1.00 = 18 DUCT SYSTEMS A X $10.00 = 19 VENTILATING FANS 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 - 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 0 CASH 0 CHECK 0 VISA El MC DATE: PROCESSING FEE $35.00 EXPIRES: CARD#: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: SCIIY� PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision leY 11707 E. Sprague Avenue, Suite 106 4100111 Spokane Valley, WA 99206 � Phone: (509)688-0036;Fax: (509)688-0037 FOR INSPECTIONS, CALL(509)688-0054 Project Address: T Permit Use: Owner: Lim 'N C,00 -Sri(' Phone (Daytime Contact): c''g' I a 13 Mailing Address: x 307'12. v\jc 0/422.3 �d)p j9 VY.6i n (B State Zip Code Contractor: — o • .License#: • Phone#: 'j p )O/3 Mailing Address: P.Com. Eck 307c1'2 L cKct n City State Zip Code *OF TOTAL DESCRIPTION OF WORK UNITS X COST • AMOUNT 1 TOILETS WATER CLOSET,BIDETS 4 2- x $6.00 = 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT 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 X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL i X $8.00 = 9 WATER SOFTENER X 56.00 = 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, 3 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 0 CASH 0 CHECK 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Inspections performed 10 days after scheduled completion to schedule call Sp okane (509)688-0195 or Fax(509)688-0037. Any re- an inspection will incur an additional $25.00 charge. le11707 E Sprague Ave,Suite 106 .....0 val y Spokane Valley,WA 99206 ROW Construction Permit Permit# ROW 04-813 Issue Date 10/15/2004 Account# Completion Date Issued by Kcummings Construction Utility Location of Property Project Description El El 4705 E 14TH driveway Comments EW DRIVEWAY APPROACH Trench Dimensions AC Cut Required Applicant/Contractor Name Licence # Individual Name Lindsey Construction Address Contractor Phone# P.O. Box 30792 509-879-3420 Spokane WA 99223- Account# Permit Fee Inspection Fee Total Fees Collected $25.00 $25.00 $50.00 Permittee Signature Approved Date 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(1/2 hour) minimum. Permittee signature constitutes an agreement to these terms and provisions. Work completed satisfactorily(signed) Date PERMIT MUST BE KEPT ON SITE Proposed Plot Plan 4705 East 14th Avenue City of Spokane Valley County of Spokane,State of Washington E 47' OF LOT 8, &W 6'OF LOT 9, BLOCK 12,WOODLAND TERRACE SCALE 1:20 I SEWER&WATER PROVIDED BY CITY OF SPOKANE ADDRESS: ZONE:UR 3.5 ROAD WIDTH:60 Pit/ FRONT: FLANKING P S 3 COMMENTS: REVIEWED BY: Iv +1 ; it K8 41 03110Ulddtl 1d3a TeiNNIfld The site plan is being submitted for the purpose of i� ) Obtaining a building permit and is a true and correct Representation of the proposal. All known property 1v Lines/dimensions,curb lines,structures and easements Qhave been identified. Also indicted are wetlands, bodies of water,steep slopes or other critical areas. \t ,, 53 Lindsey Construction, Inc.