2011, 07-27 Permit App: 11002191 Remodel Project Number: 11002191 Inv: 1 Application Date: 7/27/2011 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW BATHROOM IN BASEMENT Contact: STACHOFSKY,SAMUEL W&JAN R
Address: 12023 E 19TH AVE
C- S-Z: SPOKANE,WA 99206-5707
Setbacks: Front Left: Right: Rear: Phone: (509)924-9013
Group Name:
Site Information: Project Name:
Plat Key: 001221 Name: HILLCREST PARK 01ST ADD District: Sout
Parcel Number: 45281.0317 Block: Lot:
SiteAddress: 12023 E 19TH AVE Owner:Name: STACHOFSKY,SAMUEL W&JAN
Address: 12023 E 19TH AVE
Location::CSV SPOKANE,WA 99206-5707
Zoning: R-2 SF Res Suburban District
Water District: 011 MODERN Hold: ❑
Area: 13,934 Sq Ft Width: 95 Depth: 171 Right Of Way(ft): 50
Nbr of Bldgs: 0 Nbr of Dwellings: 1
Review Information:
Review
Building Plan Review Released By:
Originally Released: 7/25/2011 By: tmelbourn
Permits:
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
BASEMENT R R-3 VB BATHROO 0 $6,650.00 0 $6,650.00
M
Totals: 0 $6,650.00 0 $6,650.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE l SELECT $139.25
WSBCC SURCHARGE 1 SELECT $4.50
SF PLNS RVW<7999 SQ FT 1 SELECT $55.70
Permit Total Fees: $199.45
Operator: JD Printed By: JD Print Date: 7/27/2011
Project Number: 11002191 Inv: 1 Application Date: 7/27/2011 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Mechanical Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $11.00
VENTILATING FANS 1 DUCT 1 NUMBER OF $11.00
Permit Total Fees: $22.00
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 1 NUMBER OF $6.00
SINKS 1 NUMBER OF $6.00
SHOWERS 1 NUMBER OF $6.00
Permit Total Fees: $18.00
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $199.45 $199.45 $55.70 $143.75
Mechanical Permit $22.00 $22.00 $0.00 $22.00
Plumbing Permit $18.00 $18.00 $0.00 $18.00
$239.45 $239.45 $55.70 $183.75
Disclaimer:
Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information
contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for,or an approval of,any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD Print Date: 7/27/2011
Community Development Department (Staff Use Only)
Permit Center
'� 11703 East Sprague Avenue, Suite B-3 PERMIT NUMBER:
Spokane _ .,.._
Spokane Valley, WA 99206
Tel: (509) 688-0036 PERMIT FEE:
\ii.11ey Fax: (509) 688-0037
permitcenter@spokanevallev.orq
RESIDENTIAL CONSTRUCTION PERMIT APPLICATION
0 NEW CONSTRUCTION ig ADDITION/REMODEL Q ACCESSORY BUILDING
DECK ❑ OTHER
SITE ADDRESS: I 2-07- 3 E I Qt k spk4* V k I t:-.7-1 94 Za 4
ASSESSORS PARCEL NO.: LEGAL DESCRIPTION:
BUILDING OWNER NAME: 5..42 Pik L G A 17
NAME: Ilk G
144/
ADDRESS: / ; 0? 3 /a I ►•..rte JJ
CITY: 5po VQ Y'R,.E,. V 4i ! e7 STATE: w4D
4 ZIP: 9120
PHONE: 09 "� / FAX: CELL: •- 7
CONTACT NAME:
PHONE: FAX CIiLL: { .. 4 -____.)
CONTRACTOR NAME: f W --L—
MAILING ADDRESS: JUL F' ';''',11; I`
CITY: STATE: \, _ ZIP: 1� f
PHONE: FAX: eta-L>"??1"i;,
i
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
INSCRIBE THE SCOPE OF WORK IN DETAIL AND INDICATE USE & PROPOSED USE:
"feQ w•o de I per.. - aA base-v.4. ) C.iU afi rp0t..4-(fu.41oAA.ad* firii , 5)10..4•t
U..-P ,5 hI Aie 4 Shit k. ,
****YOU MUST COMPLETE THE FOLLOWING****
MARK N/A IF NOT APPLICABLE
Height to Peak: Dimensions: �� No. of Stories: Total Habitable
N) 3 x / or Ai/4 Space: b"3Z-
Main Floor S FT: Upper Floor SQ FT: Unfinished Basement SQ Finished Basement
,J 14- /V A FT: ti 14-- FT: N 44
Garage SQ FT: Deck/Covered Patio SQ Impervious Surface 30%Slopes on
til FT: N 4 Area: ta4 Property: nJ A
No. of Bedrooms: N 4 Construction Type: w•oc. Heat Source: ►•-'//k S r Septic:
TOTAL COST OF PROJECT: $ A, (v k.5-6 ov—
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1) if this permit is for construction 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) The City of
Spokane Valley permit is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be required to be submi ed and sub quently approved before this application can be processed.
Signature '`14/7 "1 Date: 7/104
Updated 1-11-11 Page 1 of 1
http://www.spokanevalley.org/filestorage/124/938/210/948/1496/Building_Permit__Residential_11-11-11.doc
RESIDENTIAL CHECK LIST DIRECTIONS:
Place a check mark in box next to each document required for complete submittal.
❑ SITE PLAN
❑ Property lines and dimensions o Setbacks to property lines
❑ Direction arrow pointing North and orientation to streets ❑ Distance between buildings
❑ Proposed/existing buildings (footprint and dimensions) ❑ Right of way/easement location &sizes
❑ Utilities, septic tank/drain field locations and distances o Driveway approach size and location
BUILDING PLANS (3 SETS) (minimum 1/8 inch scale or completely dimensioned)
❑ Elevations (Front/Rear/Sides)with roof peak and wall height including basement:
❑ Foundation Plan (crawlspace, basement or slab on grade):
o Footing sizes and locations ❑ Supporting wood cripple walls or beams
o Perimeter concrete foundation wall sizes o Thickened concrete pads supporting
o Crawlspace ventilation beams or girder trusses
❑ Floor Plan of each level (finished or unfinished)with dimensions:
o Floor Joist direction, size and spacing o Window and door location and sizes �k'
o Header, beam or concrete lintel sizes o Window well locations if applicable
❑ Brace wall panel locations ❑ Room usage labels
o Water heater and furnace locations ❑ Smoke detector locations
o Exhaust fan locations ❑Attic and crawl space access locations
❑ Deck or concrete patio sizes and locations ❑ Fire Wall construction
❑ Roof Plan:
o Engineered truss direction and spacing o Ridge, eave and valley lines
o Rafter and over frame direction, size and spacing o Beam and girder size and location
❑ Wall Section Detail including:
Roof
o Slope/roofing material/underlayment/ice dam protection o Truss or rafter size, spacing &connection
o Sheathing size and type o Attic insulation/air space baffle/ventilation
Ceiling
❑ Joist size and spacing ❑ Size of ceiling gypsum wall board
Wall
o Height/top plate/stud size and spacing/sole plate o Siding/exterior house wrap/anchor bolts
o Exterior sheathing size and type ❑ Insulation, vapor barrier, gypsum wall board
Floor
o Joist size and spacing o Sheathing or concrete floor size/insulation
Foundation Wall
o Concrete or Masonry unit width o Footing bottom to finished ground level depth
o Earth to wood separation distance ❑ Horizontal &vertical reinforcement if any
Footing
o Size o Reinforcement if any
Radon
o Passive system with 6mil vapor barrier o Active system with 6 mil vapor barrier
Miscellaneous Construction Details
❑ Deck:
o Floor plan/side view/dimensions o Footings/post/and beam size and locations
o Floor Joist/decking direction, size and spacing
0 Stairway tread rise & run and nosing 0 Handrail/Guard height&spacing
/\ Permit Center
*MS �k'aAnM �s�, 11703E Sprague Ave,Suite B-3
ane Spokane Valley,WA 99206 PERMIT NUMBER:
_Mdlley (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development permitcenter(a�spokanevallev.org
Mechanical Permit Application ,tom^ n eComme�,rcial � tJ esidential
SITE ADDRESS: /a V e? a L.- / !t S pv 14.0144. L/ - Le f °` are►
r"
Building Owner
�n J]j t Phone: `� Fax:
Name: � y'}...1�1��` �'f �))�Fj)i/�"f ���` � �p)��7 �� }�
Address: v e- Lys i% t^�.►f City: f�Z .2*, �O` I/State: - Zip: 9
Contractor
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
#UNITS
FURNACES&SUSPENDED HEATERS-INSTALLATION OR RELOCATION Up to&including 100,000 BTU
FURNACES&SUSPENDED HEATERS-INSTALLATION OR RELOCATION Over 100,000 BTU
DUCT WORK SYSTEM
HEAT PUMP/AIR CONDITIONER 0-3 TON
AIR CONDITIONER Over 3-15 TON
AIR CONDITIONER Over 15-30 TON
AIR CONDITIONER Over 30-50 TON
AIR CONDITIONER Over 50 TON
GAS WATER HEATER I Ce
GAS PIPING SYSTEM(each outlet)
GAS LOG,FIREPLACE,&GAS INSERT
APPLIANCE VENTS INSTALLATION,RELOCATION,REPLACEMENT
REPAIRS OR ADDITIONS
BOILER,COMPRESSORS,ABSORPTIONS SYSTEM 0 to 3 hp-100,000 BTU or less
BOILER,COMPRESSORS,ABSORPTIONS SYSTEM Over 3-15 hp—100,001 to 500,000 BTU
BOILER,COMPRESSORS,ABSORPTIONS SYSTEM Over 15—30 hp -500,001 to 1,000,000 BTU
BOILER,COMPRESSORS,ABSORPTIONS SYSTEM Over 30 hp—1,000,001 to 1,750,000 BTU
BOILER,COMPRESSORS,ABSORPTIONS SYSTEM Over 50 hp—over 1,750,000 BTU
AIR HANDLER(DOES NOT include ducting) Each unit up to 10,000 cfm,including ducts
AIR HANDLER(DOES NOT include ducting) Each unit over 10,000 cfm
EVAPORATIVE COOLERS(other than portables)
VENTILATION AND EXHAUST Each fan connected to a singe duct
VENTILATION AND EXHAUST Each ventilation system 1
VENTILATION AND EXHAUST Each hood served by mechanical exhaust
INCINERATORS Installation or relocation of residential
INCINERATORS Installation or relocation of commercial
APPLIANCES Range,Clothes Washer
UNLISTED APPLIANCES Under 400,000 BTU
UNLISTED APPLIANCES Over 400,000 BTU
HOOD Type I
HOOD Type II
L P STORAGE TANK
•
WOOD OR PELLET STOVE INSERT
WOOD STOVE SYSTEM—FREE STANDING
EXPIRES: VIN:
❑CASH ❑CHECK ❑VISA ❑MC
CARD#: SIGNATURE
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/MechanicalPermitApplication040309.doc
Permit Center
S"Sokane 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER:
P Spokane Valley,WA 99206
4000 ValleY (509)688-0036 FAX:(509)688-0037 PERMIT FEE:
perrnitcenter@spokanevalley.org
Community Development
Plumbing Permit Application J, n Commercial Residential
SITE ADDRESS: 1 2-6 2 3 Li i g.{-/ 'j e 6 k lev-@.. (dy 1,124(gr
Building Owner
Name: Slyt S' •• (j Phone: t ��,,, (�i' Fax:
c
Address: v3 (- j City. f�j4 y V*j State: 1 . Zip: 9, 24.
Contractor ( G F
Name: Phone: Fax:
Address: City: State: Zip:
License No: City Business Lic:
Contact/Project Manager:
Name: Phone:
#OF UNITS
PLUMBING FIXTURE ON A TRAP
TOILETS
URINALS
TUBS
SHOWERS(per trap)
Lav/Basins,Bar,Floor,Kitchen,Laundry,Utility,Janitor,Photo,X-ray,Food,
SINKS Prep/Culinary Meat
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTNER
FLOOR DRAIN Area,Case,Coil,Trench,Condensate
ROOF DRAIN/OVERFLOW DRAINS
FOUNTAIN,DRINKING
WATER PIPING/DRAIN-IN WASTE Installation,Alterations,Repair,Reversals
WATER USING DEVICE Ice and/or Coffee maker,hose bib,steamer proofer,carbonator,swamp cooler
PRIVATE SEWAGE DISPOSAL SYSTEM
WATER HEATER If Gas,See Mechanical
INDUSTRIAL WASTE PRETREATEMENT
INCEPTORS Including traps,vents except kitchen type grease interceptors functioning as fixture traps
REPAIR OR ALTERATION Water piping,drainage or vent piping
ATMOSPHERIC TYPE VACUUM BREAKER
BACK FLOW PROTECTIVE DEVICE Other than atmospheric type vacuum breakers
MEDICAL GAS
INCEPTORS
OCASH ❑CHECK ❑VISA ❑MC EXPIRES:
Card# VIN:
SIGNATURE:
CURRENT FEES AVAILABLE AT:http://www.spokanevalley.orq/under the quick links for Forms,Master Fee Schedule.
http://www.spokanevalley.org/uploads/Community Development/Documents/Forms/Building/PlumbingPermitApplication040309.doc
New project.'
Project
Previous pre-app meeting
nT1a lSmittUl Plan revisions
Cita-of Spokane�'allesTransmittal Date:
Community Development Monday-,July 25,2011
.000Valley
Department
11'03 E. Sprague Ave,Suite B3
Spokane Valley,WA 99206
Phone: 509.688.0036
Site Address: 12023 E 19TH AVE Project Number: 11002191
Parcel Number: 45281.0317
Zoning: R-2 Water District: MODERN
Fire District: FD 01
Applicant: STACHOFSKY, SAMUEL W & JAN Owner: STACHOFSKY, SAMUEL W & JAN
12023 E 19TH AVE 12023 E 19TH AVE
SPOKANE, WA 99206-5707 SPOKANE, WA 99206-5707
(509) 924-9013
e-mail: e-mail:
Contact: STACHOFSKY, SAMUEL W & JAN Occupant:
12023 E 19TH AVE e-mail:
SPOKANE, WA 99206-5707
(509) 924-9013
e-mail:
Contractor: OWNER Arch/Engineer:
( ) - 0
e-mail:
Project NEW BATHROOM IN BASEMENT
Description:
Building Landuse Engineer Utilities Health Fire Dist Assessor
APPLICATION i
PLANS
Please send all plan review and project comments via e-mail to the
highlighted individuals.
•
Target Date sheet
For ity Use On
PLUS Project t X 7-�
SpanOkane Project Address
Valley®
11703 E Sprague Ave Suite B-3 ♦ Spokane Valley WA 99206
509.720-5240♦ Fax: 509.688.0037♦ permitcenter®spokanevalley.org
As part of our on-going commitment to customer service during the review process of your project application,we are
providing you with a TARGET DATE for the initial technical application review. If for any reason we cannot meet
this date,we will contact you with a revised target date.
Your application review TARGET DATE is
The TARGET DATE is the date we estimate your project applicdtion will have had its initial technical review.It is
not the date for approval or permit issuance.
Tips for a Smoother Project Application Review
D Submit complete,accurate plans and documents.
Extra time may be required for re-submittals as project application reviewers work on multiple applications and it may be
several days before they can look at your new or revised information.
D Designate a specific contact person to communicate with the City.
While the person designated as the applicant's contact person with the City can be changed, one individual with the expertise
for dealing with reviewer comments would be the best choice for the entire review process.
D Call staff regarding the status of your project only after the target date shown at the top of the page.
Although you should be contacted on or by the target date,please feel free to contact us ifyou haven't heard from us by your
target date.Staff may contact you before the target date if the initial review is complete.By following this procedure,you will
save time and allow the reviewers to complete the work more expeditiously.
Steps in the Permit Process
1. Counter Complete. Your application has been accepted as counter complete. This means all of the required documents, as
indicated on your Pre-Application Checklist have been submitted or have been approved for deferred submittal. This does
not prevent technical staff from requesting additional information as a result of their technical review.
2.Quality Check. The next step in the process is a quality check to make sure that the application is reviewable and free from
substantive flaws that would prevent technical staff from completing the technical review once it is started. When this step is
complete,your application will be routed to the appropriate staff and remain in their review queue until it comes up for review.
3.Technical Compliance.Once an application is administratively complete,it is routed to technical staff for compliance review.
Depending on the type of project, technical staff may include multiple reviewers. You should be contacted by phone,fax,email,
or mail by your TARGET DATE once the initial technical compliance review is complete.
4. Permit Issuance. When the technical compliance review of the application is complete, including any subsequent re-
submittals, each reviewer will approve their section of the application and route it to the Permit Center.When all sections of the
application are received,a Permit Specialist will process the application and contact the person specified on your application for
permit pick-up.Information regarding fees and pre-construction meetings(if required)will be provided by the Permit Specialist at
that time.
CD-003 V-7/06-21-11 Page 1 of 1