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2003, 05-09 Permit App: BD03-376 Addition City of (s2��' 003 SPOKANE VALLEY ry - - 0037 PERMIT # 61) 03-37y BUILDING PERMIT APPLICATION Box 1 OWNER „ G/261-G-,/ KClC,yfjit/ JOB LOCATION OWNER'S ADDRESS CITY PHONE /15/ /6 4-ie, SPOiCArv5_41, / 4 q 'J)6 (5c `o? 7-x' -76 DESCRIBE JOB 4 (a i Lit,/ Of. V^..e THIS PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME OW 11Q-1" PHONE CONTRACTOR'S ADDRESS CITY CONTRACTOR'S REG.# EXPIRATION DATE (CARD MUST BE PRESENTED AND COPIED OR VEFFIED) BOX 3 CONTACT PERSON OF PROJECT s � �J/ /6.recsr%L' PHONE Se* ADDRESS //3/ 7L/tie-fr 4ve. CITY kfir12.4e1 zIP 9A2e)6. BOX 4 SEWER AVAILABILITY yk.i WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST$ 3.10 040-<9 EXISTING BLDG.VALUATION$ So .-42� BOX 6 PROPERTY TAX ACCOUNT NUMBER 95,13, 9,2V LEGAL DESCRIPTION W 601 of F /501 ®F S 0.15' 0-C w /9, off' SE y (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER `f(;C, BOX 7 BUILDING SQUARE FOOTAGE (Existing/proposed) 1ST FLOOR i00st /e60Sf ND FLOOR - 3RD FLOOR / OTHER Latch J BASEMENT FINISHED Lctile__ BASEMENT UNFINISHED 41, i DECK ta2-4 e / GARAGE '"-"t / CARPORT 4147144 TOTAL 6 e2 / Q HEIGHT TO PEAK OF BUILDING II FT. BOX 8 ( SINGLE FAMILY ( ) NEW CONSTRUCTION ( ) MULTIFAMILY(NO. OF UNITS ) ( ) EXISTING STRUCTURE ( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ. FT. ( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE— SQ. FT. BOX 9 PLUMBING FIXTURES (Including rough-ins) MECHANICAL APPLIANCES PLEASE USE THE ATTACHED PLUMBING/MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES, SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS, CONVERSION BURNERS, LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL. BOX 10 Water Service meter size(if known) Also see BOX 4 BOX 11 Septic Tank—Not generally allowed in the City of Spokane Valley. For special circumstances contact Your sewer purveyor and the Health District (See BOX 4) BOX 12 Street use may require a" Street Use Permit"for sewer, water, sidewalks, curb cuts. Contact the Public Works Department. I VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH THE APPLICATION IS MADE. OWNER/AGENT �� ey kC� < < DATE 5/Q/ wd 3 (OVER) I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercard —_ Expiration Date Print the name of the Holder Signature OFFICE USE ONLY-PLEASE DO NOT WRITE BELOW THIS LINE ZONE SETBACKS: FRONT SIDE REAR HEIGHT LIMIT PLANNING DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS SEPA: EXEMPT NOT EXEMPT FIRE DEPARTMENT APPROVAL DISAPPROVAL DATE REMARKS PUBLIC WORKS DEPARTMENT APPROVAL DISAPPROVAL DATE TYPE OF JOB: NEW RESIDENCE RES.ADD/ALT NEW INDUSTRIAL IND.ADD/ALT NEW COMMERCIAL COMM.ALT/ADD NEW MULTIFAMILY NO. UNITS MULTIFAMILY ADD/ALT TENANT IMP. ROOF OTHER OCCUPANCY TYPE OF CONSTRUCTION STORIES BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ _ BUILDING SQ. FT. @ BUILDING SQ. FT. @ _ TOTAL SQ. FT. TOTAL VALUATION BUILDING PERMIT NO. PLAN CHECK FEE RECD RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES-1 AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY DATE 111) ASSIGNED ADDRESS l • LI 5C I sotoIr 40...\4441**, 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone <- ` ,i; Spokane Valley,WA 99206 509-688-0037-Fax ,, ,.. Valley •Mechanical Permit Application PROJECT PERMIT ADDRESS: USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (ZIP) DESCRIPTION OF WORK #OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE -OR<100,000 X $15 - 2 FUEL BURNING APPLIANCE >100,000 X $19 - 3 UNLISTED APPLIANCE(ADDITIONAL FEE) =OR<400,000 X $50 - 4 UNLISTED APPLIANCE(ADDITIONAL FEE) >400,000 X $100 - 5 USED APPLIANCE(WSEC min.AFUE rating) -or<400,000 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,GAS FIREPLACE - X $10 - 13 RANGE - X $10 - 14 DRYER - i X $10 = j V 15 FUEL BURNING WATER HEATER - k X $10 - J 16 MISC.FUEL BURNING APPL. - X $10 - 17 GAS PIPING(ea.Outlet) - I X $1 - 18 DUCT SYSTEMS - X $10. ___...---....-.._v____.__.r..-__... 19 VENTILATING FANS - .. X $10 - C 20 AIR HANDLER(DOES NOT include ducting) -OR<10,000CFM X $12 - 21 AIR HANDLER(DOES NOT include ducting) >10,000 CFM X $19' 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD - X $50 - 24 TYPE II HOOD - r X $10 - )17.; 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 - 26 AIR CONDITIONER 3-15 TON X $20 - 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 30-50 TON X $35 - 29 AIR CONDITIONER +50 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: 7 ""- WVaiP:_ '� TOTAL PERMIT FEE DUE: 0 CASH 0 CHECK 0 MIME 0 1.___._ -==="' DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: li<�e aneeq,w, 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone Spokane Valley,WA 99206 509-688-0037-Fax .000%"ley • Plumbing Permit Application PROJECT PERMIT • ADDRESS: USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: PHONE#: • (street) (city/state) (ZIP) PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6 - / 2 URINALS X .$6 3 TUBS X $6 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 /'2-- 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO;X- X $6 RAY,FOOD,PREP/CULINARY/MEAT -. Li 6 DISHWASHER 1 X $6 Le 7 CLOTHES WASHER ! X $6 - LC 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 __ REVERSAL 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6 _ 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB, STEAMER,PROOFER,CARBONATOR, C X $6 - SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR:VATS,TANKS,BOILERS X $6 - 17 SPRINKLER SYSTEM X $25 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL • HOLDING TANK X $6 - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 • 20 MISC.PLUMBING FIXTURE X $6 - MOD OF PAYMENT SUBTOTAL: r MUM :ASH ❑ CHECK 0 0 .'i PLUS PROCESSING FEE �- TOTAL PERMIT FEE DUE: E: EXPIRES: i „262' E: KCARD NUMBER: ' FIORIZED SIGNATURE: tI av-. ___ } s to ‘.\\t. 1 _ T P 1 k /co , (29 61 � f S4 11 '; // 6-ara-,9,2-- -.4z, .• p f i ►RPR V€D _ L___ arc �?l�N� ;, - ....... V------------ : ' Li_____,,v.ii.,) t ; ..t. 9,,,eir,e0v....' :__ , . , N i '''f': 200 r o o ► �lfe . s Tjill t�eL 4 X3 1 (,� t u r, ,,,411:2"- � pi fad 15 �,i , ....,Hr-‘ I - i AL\Alm N . G M • P- D I l� V • V- iii-\-9 9 1 , x•17 ) ).--\@1 rk }0 . cuoc? 6 3 9 • • . e-ais vpv . t e x 91 , . i,. & 1 . ; I .4- (;q ,I,1 5.6) , , 5 ��, . T . . ` E7h/ nicri.e.riQ / EAVG1ivEFkSxa Zell S4' O$'B_?l6r t .as . s _ ( ,, • 3S J/ 1200a-�f u op 7'1'- . 2)c4.14 -k -rap' pia 4,..e, 1t . I E r ' , N$ MUST BE-K-: 1 .r C THE JOB S,iTE THIS BUILDING.SU c \fO FIELD INSPECTION CORRECTIONS ,7\ {��� ,.. PROVED BY Ayivi ,, 5/970. oss -----. ' , , t % ' '`? --{(\(�,\ ply „ / obi - _ u�_ __ 6 r r�c. ��e Q �01.rs p� - . 1_I� ?AI 406 or L-60 ',' _ ___ ,..Jv -,_ - -, la , _t,AftAiv... ..,_.__. .3 V li 'C ::5 I) .. 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