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2003, 04-15 Permit App: BD03-100 Addition, Reroof L � . x City of SPOKANE VALLEY PERMIT # RiJc-J-is BUILDING PERMIT APPLICATION Box 1 OWNERgu ?hi /7/&, 12JOB LOCATION f 3jp e �OWNERS ADDESS CITY PHONE DESCRIBE JOB / 01/ -,N5;�. 6 THIS PROPERTY IS OWNED BY: SINGLE/MARRIED Jf (XDf Qct PARTNERSHIP CORP. BOX 2 CONTRACTOR'S NAME(—><,v � � 7 4 <t-�.�5T PHONE Dg— 72 3-- '/qe CONTRACTOR'S ADDRESS e . j; ,�'e_;.-K,4 je(,CITY CONTRACTOR'S REG.#7�e' , ,-r- j 5 2- EXPIRATION DATE ' -3 - (CARD MUST BE PRESENTED AND COPIED OR VERIFIED) BOX 3 CONTACT PERSON OF PROJECT rel-L.vr,�). L.��lC PHONE,-' D —773 —5/54/ ADDRESS CITY ZIP BOX 4 SEWER AVAILABILITY WATER AVAILABILITY BOX 5 ESTIMATED PROJECT COST$ /lob cca Ca EXISTING BLDG. VALUATION$ BOX 6 PROPERTY TAX ACCOUNT NUMBER LEGAL DESCRIPTION (IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) CENSUS NUMBER LOT NUMBER BOX 7 BUILDING SQUARE FOOTAGE(Existing/proposed) 1ST FLOOR /.20 / 2ND FLOOR 3RD FLOOR / OTHER / BASEMENT FINISHED / BASEMENT UNFINISHED / DECK / GARAGE / CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING /5 FT. BOX 8 (°"e) 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 DATE (OVER) 4 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 REC'D RECEIPT NUMBER PERMIT FEE PLAN CHECK FEE PLUMBING FEE MECH. FEE TOTAL FEES WSBCC SURCHARGE ENERGY SURCHARGE OTHER CHARGES AMOUNT DUE BUILDING DEPARTMENT APPROVAL BY DATE ASSIGNED ADDRESS SCLTl OU pokane 11707 E. SPRAGUE, STE 106 V .iey SPOKANE VALLEY, WA 99206 40;0, (509)688-0036 FAX(509)688-0037 PROJECT TRANSMITTAL: TRANSMETTAL DA 1'E: SITE INFORMATION PERMIT INFORMATION Site Address: / c' E 2et.1A Permit Number:$o03-'(O6 Issue Date: Permit Use: X / DI n t Roo • G �� .:e Parcel Number: <Is'27). 2 32 Applicant: 1,5A l r to 1 c Subdivision: 4-E t � 4�Le D ' S f LZ A- DpP PO5+ Block: '3 Lot: ct Phone: Zoning: � Water Dist: jeContact: A I ULA et ��L Owner: a. p k �`�,`2- �2^� Phone• ?0 811.3.gi p7 Address: �. Contractor:_i SA n _ r J `-�`L (Pi 3/2003 Building Inspector: ��ce Of( M Setbacks-Fronto Left: t Right:tytRear: (.I APPROVALS BUILDING 4. /5—/ 3 PLANNING: `p�2aKzaA..2tt .570,3 EN ERS: : TH: SEWER: FIRE ST; 1 APPROVALS WAT ' DIST: STO '•ki ATER: OTHER: OD el L'ex, Ackl)cfi I ao'"x 5074 107.25 ©OC #11000°D 2.Z�• b- SS. 7O • 339. 2D 513 331 , Afcitk I 1 • 00 1.t 11707 East Sprague Avenu'�;Suite 106 509-688-0036-Phone • Sp0 ne Spokane Valley,WA 99206 509-688-0037-Fax Valley •Mechanical Permit Application PROJECT _ ,Q PERMIT ADDRESS: pf DOj ��` F Z/p USE: OWNER: L�)( g/a Ze / PHONE(Daytime Contact): MAILING ADDRESS: ` i i oe( 1_t Seo(f I/4tL '7 (street) (city/state) (ZIP) CONTRACTOR: } D LICENSE it: MAILING ADDRESS: PHONE It: cpC3 (street) (city/state) (ZIP) DESCRIPTION OF WORK #OF=NITS 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 - X $10 - 15 FUEL BURNING WATER HEATER - X $10 = 16 MISC.FUEL BURNING APPL. - X $10 = 17 GAS PIPING(ea.Outlet) - / X $1 = 18 DUCT SYSTEMS - / X $10 - 19 VENTILATING FANS - X $10 = 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 -- X $10 - 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: `x-$36:99"„ I V`�iC TOTAL PERMIT FEE DUE: VISA' f0 CASH 0 CHECK 0 111111111111111 0 - - DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: THIS BUILDING SUBJECT TO FIELD INSPECTION CORRECTIONS THESE PLANS MUST BE KEPT P ON THE JOB SITE I>, •c. ih ' 42 c2! G ----------- 1,11044-‘e, o2a _ 4 6Ait, c2dt f" 13108 £ „2120.211 A JAW- 'disc. D r - 4,044_ $3 74414 Cock 1 `D2ivL4)r4`� 1I APPROVED BY t I 0 w4 .,4 . . . 3e /I4c---4/s 4i-cute/ 6------‘ -0 /e73,-(_. pc,0/;:;.2 , , ,e. .---,.._e_ ,,n-,s'n ,o r-7`i er b5 - /S=O 3 /e:/,'N-C_ Fi-G"71 i',1)' 4,/re)-1 e/ .i.----.2 r'--. 03 7<<-",%-e- , 0 5 ,,,p,r7 ,e3 c-71;<- / 6-- .?.62---,v_S /e/-7,4( fv r/Pc/ ,S= 3 a-- 0 7 //< - rte!`/` _.i.._m 3;.,41/:' //r,