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2004, 10-22 Permit App: BLD-04-08076 Residence orka.0"4...._ 4 • ...„ BUILDING PERMIT APPLICATION WORKSHEET Stio ne City of Spokane Valley Community Development Department Building Division ��� 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 4000V Phone: (509) 688-0036;Fax: (509) 688-0037 REQUIRED SITE INFORMATION Street Address: /-7/7D6, /q%kkt riF (; E Q V D Assessor's Tax Parcel Number(s): or i 2 2 2004 Legal Description: IMO' PERMIT DESCRIPTION: 'Building Permit El Change in Use ❑ Grading El Manufactured Home El Relocation ❑ Tenant Improvement El Fire Safety El Other OWNER/APPLICANT INFORMATION El Owner: 67//Ad— 1=1 Applicant: Phone: '—!D/3 'Fax: (-f If 3--V /3 Phone: Fax: Address: /2D gvic 31,1 79 Z Address: ..1147)-A4_4.7,1_ 4? g9, 3 City State Zip de City State Zip Code El Contractor: za���y -� ❑ Architect: Phone: Fax: Phone: Fax: Address: Address: City State Zip Code City State Zip Code WA State Contractor License #: Contact: PERMIT/BUILDING INFORMATION HEIGHT TO PEAK: DIMENSIONS: #OF STORIES: MAIN FLOOR TO SQ. Fla `e 2N" FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: O DECK/COV. PATIO SQ. FTG: OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE: gCC5 : #OF BEDROOMS: 3 TOTAL HABITABLE.SPACE: IMPERVIOUS SURFACE 020 COST OF PROJECT: 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC SYSTEM? c,E?i , - M 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 ❑ 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 ❑ Check 0 Mastercard ❑ VISA ❑ Other Bankcard #: Expires: VIN#: Authorized Signature: • ./\64k . kk MECHANICAL PERMIT APPLICATION Sfi �ne City of Spokane Valley Community Development Department BuildingDivision alley 11707 E. Sprague Avenue, Suite 106 4 0 0 0*V Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Addr�j . 7 ( g- / Permit Use: Owner: i�1 .1-4( Phone(Daytime Contact): Mailing Address: City State Zip Code Contractor: /2r9 nidi 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 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 6 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 1,001-1,750M 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 = 13 RANGE X $10.00 = 14 DRYER X $10.60 15 FUEL BURNING WATER HEATER 1 X $10.00 = 16 MISC.FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING(each outlet) Z X $1.00 = 18 DUCT SYSTEMS r 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 D CASH 0 CHECK 0 VISA Q MC DATE: PROCESSING FEE $35.00 CARD#: EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: :» , • PLUMBING PERMIT APPLICATION pv City of Spokane Valley Community Development Department �e BuildingDivision alley 11707 E. Sprague Avenue, Suite 106 die Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 nn// �1 FOR INSPECTIONS, CALL(509)688-0054 Project Address: 4"?D, t /7 — Permit Use: Owner: `441L9 ��— Phone (Daytime Contact): Mailing Address: "41)-7!.. Z City State Zip Code Contractor: G 27 0 / Zf2e,IL License#: Phone#: Mailing Address: City State Zip Code OF TOTAL. DESCRIPTION OF WORK UNITS X COST - AMOUNT 1 TOILETS WATER CLOSET,BIDETS Z X $6.00 = 2 URINALS X $6.00 = 3 TUBS 2- X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = 5 SINKS LAVSIBASINS,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 = e GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 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 Q CASH 0 CHECK Q 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 Sjökine ( ) - re-inspection will incur an additional $25.00 charge. 11707E Sprague Ave, Suite 106 4.0000Valley Spokane Valley,WA 99206 ROW Construction Permit Permit # ROW 04-881 Issue Date 10/30/2004 Account# Completion Date Issued by Kcummings Construction Utility Location of Property Project Description 4624 E 14TH driveway Comments NEW 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 4706 East 14th Avenue City of Spokane Valley • County of Spokane,State of Washington EAST 49 FT.OF LOT 5&THE WEST 2 FT OF LOT 4,BLOCK 17&NORTH V2 OF VACATED ALLEY,WOODLAND TERRACE SCALE 1:20 I SEWER&WATER PROVIDED BY CITY OF SPOKANE ADDRESS: ZONE:UR 3.5 ROAD WIDTH:60 FRONT: FLANKING COMMENTS: REVIEWED BY: A 30 t _t V 13-0 A 12-1 `I vtnT rJ AcS K PLANNING DEPT. APPROVED 34 BY• 380 DATE: < Z° 2Z ; � s t { I \ The site plan is being submitted for the purpose of 1 Obtaining a building permit and is a true and correct Representation of the proposal. All known property © 1 Lines/dimensions,curb lines,structures and easements _ — • have been identified. Also indicted are wetlands, 'e 1 `l bodies of water,steep slopes or other critical areas. G, 1 Lindsey Construction, Inc.