2003, 04-18 Permit App: BD03-125 ResidenceCity of
SPOKANE VALLEY
PERMIT # 6003-- 12 -6 --
BUILDING PERMIT APPLICATION
Box 1 OWNER JOB LOCATION 9 J p� L LTh
DM -Lk, W P GIc1 c J7
OWNER'S ADDRESS CITY PHONE
DESCRIBE JOB
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME Lel I N6 -7l pJ Firm GS
PHONE '% f _/5/61
CONTRACTOR'S ADDRESS'PQ ! ILI I' M q CITY 5P K,4I J& vi-L,L e
y
CONTRACTOR'S REG.# LEX IN 1-1- i0 . 5JP EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PER NOF PROJECT LLA�D V PHONE — /C�
f�� L,EI\/ V TJ !� i4°
n1
ADDRESS { e • I.P,//-DLL;icly CITY 3PCKPNUE ZIP qc
BOX 4 SEWER AVAILABILITY f f✓5„DKPr►\\E CD.WATER AVAILABILITY ERA WA TE !2,
BOX 5 ESTIMATED PROJECT COST $ /`75 Orr—EXISTING BLDG. VALUATION $ N/A
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION _
Loy- cp LK 1 Pkp iicZ I o RC 1-1 / R A
PLM PtJ - S 5
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
,o2N
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR 57( / 2ND FLOOR 6 /
3RD FLOOR / OTHER / BASEMENT FINISHED 3'7” / /
BASEMENT UNFINISHED 5(01 /� DECK / GARAGE A5 /
CARPORT TO /
HEIGHT TO PEAK OF BUILDING 7S / FT.
BOX 8 () SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
(, NEW CONSTRUCTION
( ) EXISTING STRUCTUREQ
TOTAL AREA OF PROPERTY �o 0 % 3 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)
Also see BOX 4
BOX 11 Septic Tank — Not genera;ly allowed in the ity 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 0 ' KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO P ' F 4 '4 THE WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT
DATE (OVER)
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit car
Visa Mastercard Expiration Date
Print the name of the Holder Signature
v.
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
d a 11707 E. SPRAGUE, STE 106 '
SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
SITE INFORMATION
PROJECT TRANSMTIIAL:
TRANSMITTAL DATE: ,v/ -7 t)
PERMIT INFORMATION
Site Address: Li E
rod)c k LLC, 9037
Parcel Number: L/5--1) (4, 1, ptl\")
Subdivision: pail r
Block: t Lot: LA_
Zoning: (A ie. 3 - S Water Dist: `lerG
Owner: Lt,'-)O✓v-
Address: Po ( 1 14 9
spri
Building Inspector:
Keoir\ (`
BUILDINGS:
Permit Number: �3�3- � 25 -Issue Date: y (t '/o 3
Permit Use:
Applicant:
eSi CJS e-rkc -Q
0t rLe_r
Phone:
Contact: ;3(4,1 t r' tAitaa
Phone: c2,4_is c.)
Contractor: LQX am r' J
Setbacks - Front: Lf O Left:1 0 Right: Rear: 55'
APPROVALS
PLANNING:
ENGINEERS: Appriori °Orctirlo•
1000 °I) --SIL)-1--&-o 0
fLcyc Lk)/
o3
a.K. ro WWI •
SEWER-��
WATER DIST:
APPROVALS
/ /.30 -3)--)(01+.SD •
- CY C07-0 LASICClq. tp0
CZ
IL I, b20 e..00
()ar - (.055? 15 00 ct 70.00
0-00
• 00•
0.00 *
38,764.80
45,898-60
6,854.10
8,176.00
9,870-00
109,563-50
1
G(9-3 50
"00-76-
oq.95 :)0490
q.5 -c3
oq4-
4-
-00 r I uk,r4
(16.0b tkec_k
*Wane
.0.01cValley
PLUMBING. FIXTURES
DESCRIPTION
1 TOILETS
2
DETAILS
WATER CLOSET, BIDETS
# OF UNITS
,�1
x
X
COST
$6
EQUALS
AMOUNT
URINALS
TUBS
X
$6
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
X
X
$6
$6
LP
I7
LAVS/BASINS, BAR, FLOOR,
KITCHEN. LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
s
X
$6
30
6
7
DISHWASHER
x
$6
(40
CLOTHES WASHER
X
$6
8 GARPkGE DISPOSAL
9 WATER SOFTENER
10
11
X
$6
$6
ELEC HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS SEE MECHANICAL
X
$6
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6
12
13
FOUNTAINS, DRINKING
X
$6
WATER PIPING/DRAIN-IN
WASTE, VENT,
PLUMBING REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6
14
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
x
$6
WATER USING DEVICE
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
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
NITROUS, OXYGEN
X
$6
MISC PLUMBING FIXTURE
X
$6
s
>t
❑ CASIO 0 CHECK 0 -- 0
FAXED PERMITS 'WILL ONLY BE ACCEPTED WITH PAYMENT
OF A MAJOR CREDIT CARD
DATE:
BANRCARD s ER:
AUTHORIZED SIGNATURE:
EXPIRES:
c
SUBTOTAL
PLUS PROCESSING
FEE
TOTAL PERMIT FEE
DUE
PROJECT //'V
ADDRESS: 1qiUSE:
PERMrr
OWNER:
PHONE (Daytime Contact):
MAILING ADDRESS:
(street) (city/state)
(Zip)
CONTRACTOR: t
(�[rnmi..3 PL-ucm6 !&V --;TI
UCENSE #:
mot)' p fe g 7g•i<p
PHONE #: ,Ii.
1 14; ;1 _ r;vl i /
_
MAILING ADDRESS:
29 5- ma1r_ef2. 5100'<Attu
,
c - qq.. kr
(city/state)
(zip)
(street)
PLUMBING. FIXTURES
DESCRIPTION
1 TOILETS
2
DETAILS
WATER CLOSET, BIDETS
# OF UNITS
,�1
x
X
COST
$6
EQUALS
AMOUNT
URINALS
TUBS
X
$6
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
X
X
$6
$6
LP
I7
LAVS/BASINS, BAR, FLOOR,
KITCHEN. LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
s
X
$6
30
6
7
DISHWASHER
x
$6
(40
CLOTHES WASHER
X
$6
8 GARPkGE DISPOSAL
9 WATER SOFTENER
10
11
X
$6
$6
ELEC HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS SEE MECHANICAL
X
$6
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6
12
13
FOUNTAINS, DRINKING
X
$6
WATER PIPING/DRAIN-IN
WASTE, VENT,
PLUMBING REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6
14
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
x
$6
WATER USING DEVICE
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
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
NITROUS, OXYGEN
X
$6
MISC PLUMBING FIXTURE
X
$6
s
>t
❑ CASIO 0 CHECK 0 -- 0
FAXED PERMITS 'WILL ONLY BE ACCEPTED WITH PAYMENT
OF A MAJOR CREDIT CARD
DATE:
BANRCARD s ER:
AUTHORIZED SIGNATURE:
EXPIRES:
c
SUBTOTAL
PLUS PROCESSING
FEE
TOTAL PERMIT FEE
DUE
~ f
*Wane
,,r 00Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS:
DESCRIPTION OF WORK
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city/state) (ZIP)
CONTRACTOR:
I
LICENSE #:
MAILING ADDRESS:
-
PHONE #:
2
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH ❑ C
DATE: 9 —IC -63
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
8 OF UNITS
X
COST
EQUALS
AMOUNT
1
FUEL BURNING APPLIANCE
= OR < 100,000
I
X
$15
-
/
2
FUEL BURNING APPLIANCE
> 100,000
X
$19
=
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR <400,000
X
550
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
5100
-
5
USED APPLIANCE (WSEC min. AFUE rating)
= or <400,000
X
550
=
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
528
-
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
-
1
X
$10
-
/0
13
RANGE
-
X
510
14
DRYER
-
1
X
510=
/ e)
15
FUEL BURNING WATER HEATER
-
1
X
$10-
/ 0
16
MISC. FUEL BURNING APPL.
-
X
510
=
17
GAS PIPING (ea. Outlet)
-
3
x
si
-
3
18
DUCT SYSTEMS
_
X
$10
-
19
VENTILATING FANS
-
3
X
$10
/ 0
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
510
=
23
TYPE I HOOD
-
X
550
=
24
TYPE II HOOD
-
i
X
$10
/ J
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12
=
26
AIR CONDITIONER
3-15 TON
X
520
-
27
AIR CONDITIONER
15-30 TON
X
$25
-
28
AIR CONDITIONER
30-50 TON
X
$35
-
29
AIR CONDITIONER
+50 TON
X
560
=
30
LPG STORAGE TANK
-
X
510
-
31
WOOD OR PELLET STOVE/INSERT
-
X
510
-
32
WOOD STOVE - FREE STANDING
-
X
$25
=
VIENT
— —
SUBTOTAL:
PLUS PROCESSING FEE:
•.$356--
TOTAL PERMIT FEE DUE: ( A.
DATE: 9 —IC -63
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
clTt't �U
liane
.0.Mt11ey
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206
509-688-0037 - Fax
PROJECT
ADDRESS:
DESCRIPTION
PERMIT
USE:
OWNER:
X
PHONE (Daytime Contact):
MAILING ADDRESS:
AMOUNT
(street)
(city/state) (ZIP)
CONTRACTOR:
LICENSE #:
MAILING ADDRESS:
=
PHONE #:
2
(street)
(city/state) (ZIP)
PLUMBPIVG FIXTURES
vIETHOD 0
3 CASH
)ATE: EXPIRES:
3ANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, :IDETS
X
$6
=
2
URINALS
X
$6
=
3
TUBS
X
$6
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE : UILT
X
$6
=
5
SINKS
LAVSBASINS, BAR, FLOG' KITCHEN,
LAUNDRY, UTILITY, JANIT• •, PHOTO, X-
RAY, FOOD, PREP/CULINARY EAT
X
$6
6
DISHWASHER
X
$6
=
7
CLOTHES WASHER
X
$6
=
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
=
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
\
\
$6
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
=
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
=
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
CHECK
C
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
■ ■
:-_ -
TOTAL PERMIT FEE DUE:
)ATE: EXPIRES:
3ANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Spolian' e
4j Valley
Call 24 hours before inspection required
Phone 509.688-0036 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date Permit # PW
APPROACH PERMIT
1.5 E. Tiv AC .
(Address/Parcel #, if available)
Applicant Name X iAD }-+ t j'Y)-
AddressPt _6r)( / 1 -'31kTahone f94- /f /9
APPLICATION
Location of property
Contractor's Name_CP.j C A L -E Lf E LS (f) (3C j2 TE
Address , / • , q"1 , pi % ( Phone
Contractor's Reg#CPA 1 CC '7'3! %J L—Expires
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other conditions
Commercialllndustrial 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$
I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card.
lard # Expiration Date
Name of Holder
Fees Paid$ --;
I)FI'ARTN1[ 1 01: 1,,,\ 13()R ;\NI) ►\I)i'`�
REGISTERED AS PROVIDED BY LAW AS
CONST CONT GENERAL
REGIST. # EXP. DATE
CCO1 LEXINHI025JA 04/01/2004
EFFECTIVE DATE 04/01/1998
LEXINGTON HOMES INC
PO BOX 141749
SPOKANE WA 99214
I):�aih \nJ 11i.hi:1\ (i,tiur:il.
M
electric
80'
THESE PLANS MUST 8E KEPT
ON THE;JOR SITE
55'
sewer
39'
garage
house
52'
4
Lexington Homes
waiter
14915 E. 24th
Prairie rchard
Lot .Block 1
•
•
'-4
+-i
26.24'
w
VD 44.
M N
r
80'
SCALE: 1" = 20'