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2004, 09-27 Permit App: BLD-04-07771 Residence • ' BUILIDING PERMIT APPLICATION WORKSHEET � City of Spokane Valtey Comrrtunity Developrrrent Department SarY Building Division . 11707 E. Sprague Avenue, Suite 106 .4,00Valleev. - • , • Spokane Valley, WA 99206 Phone: (509) 688-0036;Fax: (509) 688-0037 REQUIRED SITE INFORMATION. - . '. • Street Address: 1 1 (D O 5 • Eb ' 2_0*k-) Assessor's Tax Parcel'Number(s)gt,OLC 1 Li c 51,v3-e4 110.-f No O2 - OY Vol,U-wu n Legal Description: '. - • PERMIT DESCRIPTION: r\J.-w C C1Y1�' c-X-e.'ft o►1 l Qp/ C �tL ,L Building Permit D Change in Use ❑ Grading ❑ Manufactured Home Relocation ❑ Tenant Improvement 0 Fire Safety ❑ Other OWNER/APPLICANT INFORMATION 1KOwner: -5066\e‘ Mc,-k.t.L.\ f7 ,t ilo(e4- }fur ❑ Applicant: Phone: oil?- 14-i8$ Fa)C,. 893-0313D-- Phone: Fax: • Address: €3.17 CS/ A/. rna.ldtrkt. Address: 11,u..0 rno.A.v i W A • 9902,5 City State Zip Code City State Zip Code ❑ Contractor: '❑ 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 1 L DIMENSIONS: ,, l #OF STORIES:. ' .. MAIN FLOOR TO SQ. FTG: 2 FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: I y (PC' vl ova _ \LI(►O FINISHEDS MENT SQ. FTG: GARAGE�Q : DEC/O . PATIO SQ. FTG: OCCUPANCYGROUP: CONSTRUCTIONTY E: HEAT OURCE #OF BEDROOMS: 3 TOTAL HABITABLE SPACE: IMPERVIOZSURFACE AREA: 2'1t2.U COST OF PROJECT: ' • 30%SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC 150" / OW- SYSTEM? SA-WV • MANUFAA TUBED 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 D BOLTING ❑ CONCRETE • ❑ REINFORCEMENT ❑ WELDING Firm Name: Phone:. Fax: Inspector(s): 0 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 prope44cyji.JL ( owner. Print Name I fl.ra -acV'ER_ Signature C.brG., 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 *lane . • City of Spokane Valley Corrfmunityj Development Department BuildingDivist ion .001VailE. Sprague Avenue, Suite 106 ey •11707 Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address: , 0 5 E 201L-- & Permit Use: Owner. • • a • �__, Alb & a . O ; Phone(Daytime Contact): 98- 88 Mailing Address: .70'-i AL a i>,/tr IL tiu�7a rt. La.. A -'02`` City State . Zip Code Contractor: License#: Phone#: Mailing Address: City State Zip Code #OF TOTAL 1 DESCRIPTION OF WORK UNITS X COST - AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 1 X $15.00 •, :• NI APPLIANCE - Mare Man 100,000 X $15.00 = 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 fess 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 BOI€ER/REFRaERATION 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 = It BOILER/REFRIGERATION More than 1,75084 BTU X $95.00 = • 12 GAS LOG,GAS INSERT,GAS FIREPLACE I • X $10.00 13 RANGE ) X $10.00 = 14 DRYER j X 510.00 = • 15 FUEL BURNING WATER HEATER X $10.00 • 16 MISC.FUEL BURNING APPLIANCE X $10.00 = 17 GAS PIPING(each outlet) 9 X $1.00 = 18 DUCT SYSTEMS X $1000 19 VENTILATING FANS "j 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 1 HOOD X $50.00 = 24 TYPE II HOOD I 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: / (f SUBTOTAL 0 CASH ,CHECK 0 VISA 0 MC DATE: 41/7.•Z[b�1 PROCESSING FEE _ $35.00 CARD#: + EXPIRES: TOTAL.PERMIT FEE DUE AUTHORIZED SIGNATURE: I a.. 1-4),(3\W i • PLUMBING PERMIT APPLICATION gri � City of Spokane Valley Community Development Department pe BuildingDivision lialley 11707 E.Sprague Avenue, Suite 106 doPSpokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 FOR INSPECTIONS, CALL(509)688-0054 Project Address: ( OS E. 2 O-f Permit Use: Owner:3SC1" V\lo...x, I cCreL 1.4nl jk.,r Phone (Daytime Contact): P- 7 'J8 Mailing Address:$70Li Al y t a(U•LI-et_ r .upvt_a,r Ca,t.( (AM ', .02S- City State Zip Code Contractor: License#: Phone#: Mailing Address: • City State Zip Code *OF — TOTAL DESCRIPTION OF WORK UNITS X COST is AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6.00 = 2 URINALS - X $6.00 = 3 TUBS — X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $8.00 = 5 SINKS LAW/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD, S PREP/CULINARY/MEAT 6 DISHWASHER I x $6.00 = 7 CLOTHES WASHER I X $8.00 = 8 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,. 1 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 $8.00 = 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, 2 X $6.00 = CARBONATOR,SWAMP COOLER J 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR: \ X $6.00 = 1 I VATS,TANKS,BOILERS 1 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK ^ F 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6:00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = ` • METHOD OF PAYMENT: SUBTOTAL Q CASH Nil CHECK 0 VISA Q MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: • TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE r(- 6\,SL r--)E 12M IT 2EI F.4�a TIZAKIM 11-TA 4 • LC :Arroal 11400 e4v7-+ Ply--i v -z— O 1 lulcl paitllts 0 Investigation fee Issue pctu.+lts . ❑ Re-Inspection fee 13 Calt(Illl(llts 0 Other • aY, ' ' ts&licE.F AALDf IQ& ?E.Vili17. 5EJA) R-m I (110400&$ck5) AND CONN€.c-TA01.1 f' S_CC.Pik."CATc.tA-LA?") HAVE. PiAth cafe l%flZyo9' E. potir-v • . ,, , ) • , \ Q)) \, ..'....'>C:S) RECEIVED . Pfe, C.0 `5T. 0', iiHol OCT 12 2004 SPOKANE VALLEY 1 6I-or y c ,,,,,e,,, .,e PLANNING DEPT. APPROVEDcOmDEPARTMENT OF mtINITY DEVELOPMENT BY.ifa- ' '.- I DATE: 10/0101- - 0 r -1(..\ 1 00. 0 0 S89•51 '23"E Lai CD .0 ••• 1 . tr • 1 sv.......:4 [ p . .:. 1. ' 0 Lii 0ic * Z 0 k___________60 I A K----19 16 --------1 to`...; 0 .. ------7---1- '.......- i / • o 25-__ 4 p it-Keof,t, rt.:- 7 . _ ., ... ici /' ) .25' 0 ...•*....; ih, 1,1A 00 • • ••••••••••••••••••••••••• • i• • . 4 IN NE39 .54' 00* W ---- — ______ 1 r - t . , immonv 2 0:I\ ike.-/ dr MOO S89'51'2.3I *cii4 dt, . 7-- 1, i (40 t 5-i., FT. d , .s,,, ,,, „ ,,, — i e , I . Sewer line ikAi )42 L/01.1 • ,_-4 --- oft, .--'. ent . ADDRESS , .0 IMO - ,0 ZONE ' ,DIMPIAL °I° - `."' -.-' 1 r I , ROAD WIDTH --,I 5- FRONT _ 0....... =,,..l: A COMMENTS IMINVill • \\r' ,\., ,----- REVIEWED BY l'fplinplMAK./ ' / ii , Ira o, , This site pion is being obb,ii:siietesnsd aN0ebOnu.Wile1d4glinNlitgshOepI.mWpAlle*a%gadmsaolenlieltiondtdela.cd lieis NgmtaoiIeerhe ktunaaeonrwd eapnenadpsecreotomlosapreereendrctt•syst. 1 -----1- -.---- C I 1 Oididwn NNP iNh atm - • .Il.i.. i L-Kcbc,t.LI, --, • 5 y qi• lI Lig' /A -, 4' • nntp• ___V__•_-‘2, - se Al /51 69) 51" ' .116! • 1----i_di 2* Border Easement T n . ......./..,01, ,vs-' , v i • ., le?"1(41 • Found 1/2" !I. ; 1 ......... ............. . ........,.... Iv iatre, „2.2.4L4 IIIMIN INIIIIIIIIMM140,14. . el......"111010"......4.11111111~1~IPPOOMMO _ Ineinliiiii 1 0 IP•ir• • Po .-Iii A\)-e. ...._., 0t I DEPARTMENT OF COMMUNITY DEVELOPMENT opmalle CURRENT PLANNING 1e ADMINISTRATIVE EXCEPTION .0,00Val +,T APPLICATION AND DETERMINATION PART I APPLICANT: 4.SO r1 ► " L OSKe y MAILING DRESS: 7o / ,4 • Alai vent] Q CITY:IVcAdy t Li.V tk• STATE: t/ ZIP: cnDeS- PHONE:(HOME) 3--CDYS/ (wow() '7 ?g- 7 c$g (CELL) NOTE:IF APPLICANT ISSN NOT THE OWNER,INCLUDE WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW LEGAL OWNER: �J CI,5C9Y\ I' \O )(e MAILING ADDRESS: 64.•^1 or .Lerlie-- CITY: STATE: ZIP: PRO'NE:(h o E) — yS (wormy (CELLT Q 27©TAX PARCEL NO: S y STREET ADDRESS OF SITE: 11005- 6---1 Q• -p o d_ LEGAL DESCRIPTION: kite] yCif 544 P(49o, ©g-Oy ff SECTIONS) 2.gTOWNSHIP 1 a �`� RANGE tic/ ZONING CLASSIFICATION: (A 1 COMPREHENSIVE PLAN CATEGORY: TYPE OF ADMINISTRATIVE EXCEPTION REQUESTED: /0/Un T 1 L 0 n Fro,n-i- 6 �ex r c , j ' r5 viPPc9ec�() -I-d Sef (20 Set Ate k Or< gA rr j EXPLAIN REASON FOR REQUEST: 1)I C. n eb reg., I L �L e re. Pr o pe I y o F re)&Ct. APPLICABLE SECTION(S)OF ZONING CODE: /`7' � SGS C a`0(3)NOTE: A SITE PLAN AND SUPPORTIVE DOCUMENTS SHALL BE INCLUDED WITH THIS APPLICATION PART II LEGAL OWNER SIGNATURE (Signature of legal owner or representative as authorized by legal owner) I, so tu, '.l , (print name) SWEAR OR AFFIRM THAT THE ABOVE RESPONSES ARE MADE TRUTI LLY AND TO THE BEST OF MY KNOWLEDGE. I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA PROPOSED FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER, ATTACHED HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY ACTIONS ON HIS/HER BEHALF. ADDRESS: / ADDRESS: 0n 1 A)• ► LL� (y'e- PHONE: 50q W3- 6 3 3 0 I �l v wa_rk talk_ tAJA ZIP: 91025 025 (Ci (State) �.-- r09 -0y (Signator (Date) NOTARY (For Part lIabove) STATE OF_WASHINGTON ) ss: COUNTY OF SPOKANE ) SUBSCRIBED AND SWORN to before me this 0') c6 day of lam-/dl ,2004 91\111 Nip 41 ,, EtiO • 7k e NOTARY SIGNATURE' .- = y Notary Public in and for the State!of Washington 40-9 Avon E: Residing at: GAAP— V tA& 14"blA OF W Pg�\,� D to ss My appointment expires: O PART III (To be completed by the PI Sta � DATE SUBMIT ED: �ti 2'/ RECEIVED BY:, a � l� - v� FEE: ((( FILE No.: C�" 2 'S t)4 PART IV DETERMINATION File No: AE - The Department of Community Development finds that the information provided by the applicant and required compliance with the City of Spokane Valley Zoning Code and all other development regulations, does /does not adverse affect on the adjacent properties nor the public's general health, safety and welfare. The Department of Community Development approves/ denies this"Administrative Exemption"as conditioned below,for the property described in Part I,pursuant to Sections 14.506.000 and 14.506.020 of the Zoning Code. This administrative exception is subject to the following conditions of approval: 1) This administrative decision shall apply to the subject property indefinitely and may be transferred to future property owners, heirs or any successor in interest to the property subject to the conditions of approval contained herein. 2) The applicant and property owner shall comply with all requirements and regulations of the Zoning Code. 3) The applicant shall comply with all applicable development regulationsand standards. 4) The applicant and property owner shall comply with the following additional conditions: et 6-4 tae Cir"- rkQ kti\ cil° 1901v\Hc4k ear:14-4,:d> 06 Svc irk74 6404VIVIceg. tAce5 This administra ' e exception is-hereby approved this �" day of fak. di" .1141 20Approved by. .�"�- � Title: 'fr`�z." �r� � 1- r flehiNr. Under Section 14.412.041 of the City Zoning Code, any person aggrieved by this administrative determination has the right to appeal this administrative decision to the City of Spokane Valley Hearing Examiner. An appeal must be filed by submitting the appropriate appeal application together with the required fee to the Department of Community Development Current Planning,within fourteen(14) calendar days after the decision is issued. Upon receipt of a complete appeal application,a public hearing will be scheduled. For information or questions,please call(509)921-1000 Rev 6/03