2009, 07-21 Permit App: 09002137 Fire Suppression System Project Number: 09002137 Inv: 1 Application Date: 7/21/2009 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: FIRE SUPPRESSION SYSTEM Contact: OXARC INC
Address: 4003 E BROADWAY AVE
C-S-Z: SPOKANE WA 99202
Setbacks:Front Left: Right: Rear: Phone: (509)535-7794
Group Name:
Site Information: Project Name:
Plat Key: 005262 Name: AUTUMN CREST 03RD ADD District: East
Parcel Number: 45261.4209 Block: Lot:
SiteAddress: 15217 E 22ND CT Owner:Name: IWATA,SUSAN L
Address: 15217 E 22ND CRT
Location::CSV SPOKANE VALLEY,WA 99037-949
Zoning: R-2 SF Res Suburban District
Water District: 010 VERA Hold: ❑
Area: 11,421 Sq Ft Width: 80 Depth: 145 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .; ...
Review
Fire District Review Released By:
Originally Released: 7/21/2009 By: THARVEY
Fire Safety Permit
Contractor: OXARC INC Firm: OXARC INC
Address: P.O.BOX 2605 Phone: (050)900-0000
SPOKANE,WA 99220
Item Description Units Unit Desc Fee Amount
City Fire Procssng Fee 1 Select $37.00
Suppression Sys 1-5 Noz 1 Select $110.00
Permit Total Fees: $147.00
Operator: JD Printed By: jmm Print Date: 7/21/2009
Project Number: 09002137 Inv: 1 Application Date: 7/16/2009 Page 1 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
;wa_. w::- ..::-:._...�..:sa-�7r`a�ura +a` c�� --: ,:.�..•l�-��:.�^:».` .k-,.., ..:�7�ti��.�.k...p
Permit Use: FIRE SUPPRESSION SYSTEM Contact: OXARC INC
Address: 4003 E BROADWAY AVE
C-S-Z: SPOKANE WA 99202
Setbacks:Front Left: Right: Rear: Phone: (509)535-7794
Group Name:
Site Information Project Name:
s .w, ami
Plat Key: 005262 Name: AUTUMN CREST 03RD ADD District: East
Parcel Number: 45261.4209 Block: Lot:
SiteAddress: 15217 E 22ND CT Owner:Name: IWATA,SUSAN L
Address: 15217 E 22ND CRT
Location::CSV SPOKANE VALLEY,WA 99037-94
Zoning: R-2 SF Res Suburban District
Water District: 010 VERA Hold: ❑
Area: 11,421 Sq Ft Width: 80 Depth: 145 Right Of Way(ft): 50
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: ra � ... . -: ..*. ;a ,
Review
Fire District Review Released.By:
Permits: r=. _ - r ;ea ..:AIsM
Fire Safety Permit
Contractor: OXARC INC Firm: OXARC INC
Address: P.O.BOX 2605 Phone: (050)900-0000
SPOKANE,WA 99220
Item Description Units Unit Desc Fee Amount
City Fire Procssng Fee 1 Select $37.00
Permit Total Fees: $37.00
iu 2°59
1 7
Operator: JD Printed By: JD Print Date: 7/16/2009
Project Number: 09002137 Inv: 1 Application Date: 7/21/2009 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes
Payment Summary:
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Fire Safety Permit $147.00 $147.00 $0.00 $147.00
$147.00 $147.00 $0.00 $147.00
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: jmm Print Date: 7/21/2009
Project Number: 09002137 Inv: 1 Application Date: 7/16/2009 Page 2 of 2
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Notes: ,
Payment SUMMarV: .0 meZagt,==- "
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Fire Safety Permit $37.00 $37.00 $0.00 $37.00
$37.00 $37.00 $0.00 $37.00
Disclaimer:
Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information
contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for,or an approval of,any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD Print Date: 7/16/2009
unix
Permit Center
Spokaane 11707 E Sprague Ave, Suite 106 PERMIT NUMBER: Zi
4200,0ValleV Spokane Valey,WA (509) PERMIT FEE:
.J (509)688-0036 FAX: (509)688-0037
Community Development www.spokanevalley.ore.com
Fire Safety
Permit Application
SITE ADDRESS I5?/ E, 22 A.16 ,4115_
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Building owner Contractor
Name: f li 04-5(2":6 h' FIM' )3ti S'/AIS Name: OXmLC
Manager/Contact Person: 5(4/L 4r.,J,4/7/4 Address: 3Y L'_/ _ i/7, ,vim f_09
Address: 15 2 1 1 22.A.J0 AWL City: S5�KA .J,Z State:/,/, _ Zip: L
City:qO Z M VC/ State: 1:./4- Zip: ?u6 Phone: - 1x110 Fax: 5z c , `J
Phone: yw Ac,ip/ Fax: JJ /4- Lic No.O 4 4t4 3tDc.tL
Occupant of Structure .5;44-111: A-$ ,4, ;; 1 City Business Lic No: L g(? '-
Name: .SA-t iC /J-r igoctiIZ
Contact Person z-
Name: 0)4/9(2,,C_ t6C ( O 3 CZC-4SS(ZCU t,
Phone: 755--06.51 -T Ito 37a
'_EY
Cost of Project: $ y 00 JUL 1 2009
FL)4411 o WirEd, .
BY:
Describe the scope of work in detail:
. .ST.g--L-L F i¢ A-NS ir,L 010a 36AL IIID Ft 1-h: i, pf sS-'o,.J Q
U L 360 5T4-/J ,m o S /Aim .4- CCA-5Sd&vii U/274/1— /1 Zvi/4 SST d /
Fire Sprinkler # of Heads Fire Alarm Paint Booth
Tent Fireworks Display Blasting Date/Time
Above/Underground Storage Tank Size
Other:
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.6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be .rocessed.
Signature 2C • s Date 1-- i,7 - 07
Method of Payment: (Fax0 permit applications will only be accepted with major bankcard)
❑ Cash leF Check 0 Mastercard 0 VISA 0 Other
Bankcard#: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
cos FIRE VV<<F
FIRE 4
DEPARTMENT
10319 EAST SPRAGUE AVE. •SPOKANE VALLEY,WA 99206-3627•(509)928-1700•FAX(509)892-4127
www.spokanevalleyfire.com
PREVENTION DIVISION
July 21, 2009
Permit#: 09002137
Project Address: 15217 E. 22nd Court
Project Description: Hood Suppression —Residential Cookie Frying Business
Applicant: Oxarc Fire
4003 E. Broadway Avenue
Spokane, WA 99202
535-7794
RE: Permit Acceptance
Attn: Bob Rousselle
The Spokane Valley Fire Department approves the issuance of the permit for the hood suppression
system for 15217 E. 22nd Court(Residential Cookie Frying Business).
For inspections call 928-1700. Provide a minimum of 24 hours notice.
If there are any questions please do not hesitate to call.
Sn e'r�ely,
'= g� /l l c
L
Traci Harvey r
Fire Protection Engin, r
Spokane Valley Fire epartment
Cc
Jodi Main City of Spokane Valley
Jenna Davis City of Spokane Valley
Q:\Dept Data Unshared\Prevention Unshared\Building Files\17th-32nd -Master Property\22nd Ct E 15217 Res Hood System.doc