2005, 01-06 Permit App: 05000058 Remodel Project Number: 05000058 Inv: 1 Application Date: 01/06/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
ProjectInformation:
............................................................................................................
Permit Use: BASEMENT REMODEL,TOILET,2 SINKS,TUB Contact: SENTRY REMODELING
Address: 15807 E 17TH
C-S -Z: VERADALE,WA 99037
Setbacks: Front Left: Right: Rear: Phone: (509)228-9464
Group Name:
SiteProject Name:
Information:
.........................................
Plat Key: 003865 Name: RIDGEMONT EST NO 3 District: East
Parcel Number: 45251.0811 Block: Lot:
SiteAddress: 16615 E 23RD AVE Owner: Name: LEVEQUE,JIM&TINA
Address: 16615 E 23RD AVE
Location::CSV SPOKANE VALLEY,WA 99037
Zoning: UR 3.5
Water District: 010 VERA Hold: ❑
Area: ),536.00 Acres Width: 100 Depth: 193 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Site Plan Review Released By.
N/A
Originally Released: 01/06/2005 By: ddompier
Plan Review Released B
Originally Released: 01/06/2005 By: ddompier
ermits: ......................................................................................................................................................................................
P
Operator: DMD Printed By: DMD Print Date: 01/06/2005
Project Number: 05000058 Inv: 1 Application Date: 01/06/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: SENTRY REMODELING Firm: SENTRY REMODELING
Address: 15807 E 17TH AVE Phone: (509)228-9464
VERADALE,WA 99037
This Application: Total Project:
Description Gm Type Notes Sq Ft Valuation Sq Ft Valuation
RESIDENCE R-3 VB BASEMENT 0 $27,587.00 0 $27,587.00
REMODEL
Totals: 0 $27,587.00 0 $27,587.00
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $421.55
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $168.62
Permit Total Fees: $594.67
Mechanical Permit
Contractor: SENTRY REMODELING Firm: SENTRY REMODELING
Address: 15807 E 17TH AVE Phone: (509)228-9464
VERADALE,WA 99037
Item Description Units Unit Desc Fee Amount
VENTILATING FANS 1 NUMBER OF $10.00
Permit Total Fees: $10.00
Plumbing Permit
Contractor: JERRY'S PLUMBING Firm: JERRY'S PLUMBING
Address: 106 S. BARKER RD Phone: (509)926-5610
GREENACRES,WA 99016
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 1 NUMBER OF $6.00
SINKS 2 NUMBER OF $12.00
TUBS 1 NUMBER OF $6.00
Permit Total Fees: $24.00
Operator: DMD Printed By: DMD Print Date: 01/06/2005
Project Number: 05000058 Inv: 1 Application Date: 01/06/2005 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
OK TO ISSUE SEWER PERMITS PER BILLY 5/17/95 CKF
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $594.67 $594.67 $0.00 $594.67
Mechanical Permit $10.00 $10.00 $0.00 $10.00
Plumbing Permit $24.00 $24.00 $0.00 $24.00
$628.67 $628.67 $0.00 $628.67
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: DMD Printed By: DMD Print Date: 01/06/2005
- BUILDING PERMIT APPLICATION WORKSHEET
San orm 01/1\11110k of Spokane Valley Community Development Department
poKaneBuilding Division
11707 E. Sprague Avenue, Suite 106
400*`alle Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: / ' 2/C--" 73 -A-it 0,3
-.A Doc/
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
,Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: ❑ Applicant:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City State Zip Code
Contractor: .,/ -_ . 4 Architect:
s�(_ ❑
Phone: _f ',�'Tc i x: Phone: Fax:
Addre : Address:
iy
1111FAMIIIMP z,City State ip Code / City State Zip Code
WA State Contractor License #3p 0/(0,f Contact: " cry /47‘..'----;.
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: DIMENSIONS: #OF STORIES:
MAIN FLOOR TO SQ. FTG: 21713 FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: HEAT SOURCE:
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
.�, g) 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC
J SYSTEM?
MANUFACTURED 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 J
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
❑ BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
I nspector(s):
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 property owner.
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
PLUMBING PERMIT APPLICATION Community Development Department
,r uBuilding Division
IL
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
401/Valley For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206
Project Address: Permit Use:
Owner. Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL 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 X $6.00 =
LAVS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER X $6.00 =
7 CLOTHES WASHER X $6.00 =
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,CONDENSATE X $6.00 =
ROOF DRAINS/OVERFLOW
12 DRAINS X $6.00 =
13 FOUNTAINS,DRINKING X , $6.00 =
WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR,
14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 =
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER X $6.00 =
PROOFER,CARBONATOR,SWAMP COOLER
VACUUM BREAKER,CHECK VALVE,
17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 =
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00
MISCELLANEOUS PLUMBING
20 FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 - =
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
0 CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
MECHANICAL PERMIT APPLICATION Community Development Department
Building Division
Phone: (509)688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
denalkY
For Inspections,Call(509)688-0054 Spokane Valley, WA 99206
Project Address: Permit Use:
Owner: Phone(Daytime Contact):
Mailing Address:
City State Zip Code
Contractor: License#: Phone#:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 FUEL BURNING APPLIANCE Equal to or less than 100,000 X $12.00 =
2 FUEL BURNING APPLIANCE More than 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 =
5 USED APPLIANCE(WSEC min.AFUE rating) Equal to or less than 400,000 X $50.00 =
6 USED APPLIANCE(WSEC min.AFUE rating) More than 400,000 X $100.00 =
7 BOILER/REFRIGERATION 1-100M BTU X $12.00 =
8 BOILER/REFRIGERATION 101-500M BTU X $20.00 =
9 BOILER/REFRIGERATION 501-1,000M BTU X $25.00 =
10 BOILER/REFRIGERATION 1,001-1,750M BTU X $35.00 =
11 BOILER/REFRIGERATION More than 1,750M BTU X $60.00 =
12 GAS LOG,GAS INSERT,GAS FIREPLACE X $10.00 =
13 RANGE X $10.00 =
14 DRYER X $10.00 =
15 FUEL BURNING WATER HEATER X $10.00 =
16 MISC.FUEL BURNING APPLIANCE X $10.00 =
17 GAS PIPING(each outlet) X $1.00 =
18 DUCT SYSTEMS X $10.00 =
19 VENTILATING FANS / 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 $15.00 - =
22 EVAPORATIVE COOLERS X $10.00 =
23 TYPE I HOOD X $50.00
24 TYPE II HOOD 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 =
33 REPAIR&ADDITIONS X $15.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST X $12.00 =
36 INCINERATOR-RESIDENCE X $19.00 =
37 INCINERATOR-COMMERCIAL X $22.00 =
METHOD OF PAYMENT: SUBTOTAL _
0 CASH 0 CHECK 0 VISA 0 MC DATE: PROCESSING FEE $35.00
CARD#: EXPIRES: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: