2003, 09-08 Permit App: BLD-03-02448 ResidenceCity of
SPOKANE VALLEY
Box 1 OWNER
PERMIT # 01-H' 1d
BUILDING PERMIT APPLICATION
JOB LOCATION
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB
4774
VaQIIPPler btiP
ofic37
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME
CONTRACTOR'S ADDRESS
t PHONE ___
boic 5PokilivE
CONTRACTOR'S REG.# LE 1 N H I O X T A" EXPIRATION DATE 4 I 04
(CARD MUST BE PRESENTED AND COPIE 0 VERIFIED)
BOX 3 CONTACT PERSON OF PROJEC i,I! [ MN- 1, ADD 1 F PHONEq�L/—/5 q
ADDRESS me Z3 a,bovc CITY ZIP
BOX 4 SEWER AVAILABILITY \]
ok lie. WATER AVAILABILITY V C
BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER
DESCRIPTION
PLAT PI - I$ - oI
(IF NECESSARY, PLEASE SUBMIT A SEPARAT .PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)
3RD FLOOR /
BASEMENT UNFINISHED( /
CARPORT / TOTA
OTHER
DECK
1ST FLOOR
BASEMENT FINISHED
HEIGHT TO PEAK OF BUILDING
F
BOX 8 ) SINGLE FAMILY
) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY ID tee_ SQ. FT.
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) cJ 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 FU-THER THAT IAM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO PERFOOR. •"" ICH THE APPLICATION IS MADE.
OWNER / AGENT
DATE
'P/63
(OVER)
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
QTI i.
S o1e
mo, Valley
MECHANICAL PERMIT APPLICATION
LJECT !�
PRODRESS: it4qoJF,
AD
PERMIT
USE:
PHONE (Daytime Contact): 49, -/5/s/
OWNER:
MAILING ADDRESS:
�f j
�
q/L//2vq i7
EQUALS
(ci /state) - (zip)
coo ; To
►
r j .
,
f
Lt s
FAVI _' /O & UW
, DD.,2ES :
$15
-�
Vp..,-I/atxt
HONE*
z
FUEL BURNING APPLIANCE
>100,000
(street) (city/state) (zip)
•
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: ��
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR<100,000
1
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
MISCELLANEOUS FUEL BURNING APPL
-
X
$10
=
17
GAS PIPING (ea. Outlet)
-
_ =3
x
$1
=
18
DUCT SYSTEMS
-
X
$10
=
19
VENTILATING FANS
-
li--..
X
$10
=
20
AIR HANDLER (DOES NOT include ducting)
=OR<10,000CFM
X
$12
=
21
AIR HANDLER (DOES NOT Include ducting)
>10,000CFM
X
$19
=
22
EVAPORATIVE COOLERS
-
X
$10
=
23
TYPE 1 HOOD
-
X
$50
=
24
TYPE 11 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
+50TON
X
$60
=
30
LPG STORAGE TANK
-
X
$10
=
31
W000 OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
=
;era_
_I__ _
WITH PAYTHENT
CARD
SUBTOTAL
l
• CASH • 'SCK • MOM •
PLUS PROCESSING
FEE
$35.00
FAXED PERMITS WILL ONLY BE ACCEPTED
OFA MAJOR CREDIT
�/Jr/J�
AA•i"C. I l7 n, CVD'I��
TOTAL PERMIT FEE
D U E
•
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: ��
a'rt
SD'lik ne
Valley
PLUMBING PERMIT APPLICATION
PROJECT
ADDRESS:
�I
OWNER
4111
MAILIN I, •RE- / 1/0 4."/ "Iv'
stree
CONT
MAILING AD ESS:
PERMIT
USE:
• PHONE
aytime Contact):
(city/state)
(zi
LICENE #:S
C Ir q?
PHONE*:
/7C
(street)
1
2
3
4
5
6
7
8
9
10
11
DESCRIPTION
TOILETS
PLUMING FIXTURES
(city/state)
DETAILS
# OF UNITS
X COST
WATER CLOSET, BIDETS
x
URINALS
TUBS
X
X
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
BATH, STALL, ON-SITE BUILT
X
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
x
$6
$6
$6
$6
$6
$6
GARBAGE DISPOSAL
WATER SOFTENER
X
$6
X
$6
ELEC HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS SEE MECHANICAL
X
EQUALS
AMOUNT
s
$6
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6
12
13
14
15
FOUNTAINS, DRINKING
x
$6
WATER PIPING/DRAIN-IN
WASTE, VENT,
PLUMBING REVERSAL
SEWAGE EJECTOR
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6
WATER USING DEVICE
GRINDER, SUMP PUMP
X
$6
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
3
X
$6
16
CROSS CONNECTION
DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR:
VATS, SUMPS, TANKS, BOILERS
X
17
18
SPRINKLER SYSTEM
INTERCEPTORS
X
$6
_
$25
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6
19
20
MEDICAL GAS per outlet
MISC PLUMBING FIXTURE
NITROUS, OXYGEN
X
$6
❑ CASH 0 CHECK 0 � ❑
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT
OF A MAJOR CREDIT CARD
DATE:
BANK
AUTHORIZED SIGNA
X
$6
SUBTOTAL
PLUS PROCESSING
FEE
TOTAL PERMIT FEE
DUE
$35.00
1
.„0"Valley
Call 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date 1 ! 03 Permit # PW o3 -- 'g 7
APPROACH PERMIT
APPLICATION
Location of propej, 46/0-3
(Addres arcel #, if av - a • le
Applicant Na i i ,.til �-
Address U!If ` 1 i R717hfone/c2/1'46161
lit 'kJ
Contractor's Name 44,iTLL_-
Address
j
Phone
Contractor's Reg# - J k H- 1 Expires 4p 704t
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other conditions
Commercialilndustrial Driveway
Rural Road Section
Sidewalk Repair/Construction
See construction requirements and details on reverse. Bond/insurance certification must be on
file with the City.
SPECIAL CONDITIONS:
PERMIT FEE $
Inspection Fee$
1 hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
Card # Expiration Date
Name of Holder
Signature
Fees Paid$ Date init
MAY 27 2003 10:44 FR
i u tiyGl�l7ti r. e��r��
STiNfia`
.000,
CITY OF SPOKANE VALLEY
DEPARTMENT OF PUBLIC WORKS
11707 EAST SPRAGUE AVENUE
SPOKANE 'VALLEY, WA 99206
(509). 921-1000
SWALE LOT PLAN
AGREEMENT
11/ 5 07 2 L,
in consideration of the issuance of a building permit for Lot ( ), Block ( F ), {.
Spokane Valley file number ( ):
The Applicant has deposited $1,000 with City of Spokane Valley Public Works Department as
security for full and faithful performance by Applicant respecting the drainage swale/ditch system,
sod and performance and other work as is incidental and related thereto in accordance with the
accepted Swale Lot Plans and specifications as submitted to and accepted by the City of
Spokane Valley Public Works Department.
The Applicant shall request or cause to be requested a final inspection of the drainage
Swale/ditch system, sod and performance, by City of Spokane Valley Public Works. The applicant
shall perform a field test of the drainage swale/ditch system, sod and performance, by flooding
the swale to the design volume of the accepted Swale Lot Plans, in the presence of a City of
Spokane Valley inspector. if the drainage swale/ditch system, sod and performance, conforms to
the accepted Swale Lot Plans of file with the City of Spokane Valley, and performs as designed in
the field test, the Public Works Department shall release the deposit back to the Applicant.
The Applicant hereby agrees that should the drainage swate/ditch system, sod and performance,
not be constructed in accordance with the accepted Swale Lot Plans and/or fail to pass a field
test within six months of final inspection approval by the Public. Works Department, the deposit
shall be forfeited to the City of Spokane Valley Public Works Department. The City of Spokane
Valley may use the monies forfeited to bring the drainage swale/ditch system, sod and
performance and other work as is incidental and related thereto into compliance with the
accepted Swale Lot Plans on file. The Applicant shall also agree to be responsible for any cost
incurred by the City in bringing the drainage swale/ditch system, sod and performance into
compliance with the accepted plan , which are in excess of the deposit.
Dated this ay of / , 2006 .
Monies to be returned to:
NAME O MP Y fA *� ./L t i _.: t , Ari
Address AN
City, State
Phone
Signed
0/4,6/idh&ek
.1"\*Illeftx
Sj�1'
11707 E Sprague Ave Suite 106 • Spokane Valley WA 99206
509.921.1000 • Fax: 509.921.1008 ♦ cityhall®spokanevalley.org
Letter of Transmittal
To: Lexington Homes From: Kathy Cummings
Company: Dept: BUILDING DIVISION
Fax:
Pages: 1
Date: 03/09/04
Re: Residential Occupancy Approval CC:
Per your request, this is to confirm that our records indicate a final inspection was
made on January 26, 2004, and occupancy approved for the permit use listed
below:
Address:
Owner:
Parcel No.:
Permit No.:
Permit Use:
14903 East 24th Avenue
Lexington Homes
45261.6105
BLD 03-02448
Residence w/Attached Garage
Should you have any further questions, please contact this office between the
hours of 8:00 AM and 5:00 PM, Monday through Friday
Thank You
Kathy Cummings
Permit Specialist
in
M
11'
gas
elect.
39'
garage
80'
56'
58'
house
i
40'
•
sewer
water
11'
80'
Lexington Homes
14903 E. 24th
Prairie Orchard
Lot 5, Block 1
in
M
APPROVED BY
SCALE: 1" = 20'