2005, 04-21 Permit App: 05001280 Addition Project Number: 05001280 Inv: 1 Application Date: 04/21/2005 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: 9 X 26 LIVING RM&BATH ADDITION&9 X 4 Contact: PATRICK,JOE
DECK Address: 11103 E 32ND AVE
C-S-Z: SPOKANE VALLEY,WA 99206
Setbacks:Front EXI Left: N/ Right: 5 Rear: EX Phone: (509)499-1545
Group Name:
Site Information• Project Name:
Plat Key: 001393 Name: KOKOMO TOWNSITE(FEES) District: Sout
Parcel Number: 45283.5506 Block: Lot:
SiteAddress: 11103 E 32ND AVE Owner:Name: PATRICK,JOE
Address: 11103 E 32ND AVE
Location::CSV SPOKANE VALLEY,WA 99206
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 70
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information: .,:
Review
Site Plan Revie 1' IRele. ed By: .
1\lak4 NAnorid-, QA._)
ti 6
Plan Review Released By:
7 ilibm
Operator: K_C Printed By: K_C Print Date: 04/21/2005
Project Number: 05001280 Inv: 1 Application Date: 04/21/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Building Characteristics
Group: R-3 Type: VN
Total Area 234
Building Height 20
Stories 1
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
DECK R-3 VB 36 $540.00 36 $540.00
RES ADD R-3 VB 234 $17,475.12 234 $17,475.12
Totals: 270 $18,015.12 270 $18,015.12
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $307.25
STATE SURCHARGE 1 SELECT $4.50
RESIDENTIAL PLAN REVIEW 1 SELECT $122.90
Permit Total Fees: $434.65
Mechanical Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
VENTILATING FANS 1 NUMBER OF $10.00
Permit Total Fees: $10.00
Plumbing Permit
Contractor: OWNER Firm: OWNER
Phone: (000)000-0000
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 1 NUMBER OF $6.00
SINKS 1 NUMBER OF $6.00
TUBS 1 NUMBER OF $6.00
Permit Total Fees: $18.00
Operator: K_C Printed By: K_C Print Date: 04/21/2005
s i
Project Number: 05001280 Inv: 1 Application Date: 04/21/2005 Page 3 of 3
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
Building Permit $434.65 $434.65 $0.00 $434.65
Mechanical Permit $10.00 $10.00 $0.00 $10.00
Plumbing Permit $18.00 $18.00 $0.00 $18.00
$462.65 $462.65 $0.00 $462.65
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: K_C Printed By: K_C Print Date: 04/21/2005
tit:1,c Wel,
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
SP cI� o ne Buildin9 Division
Valle 11707 E. Sprague Avenue, Suite 106
400001Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: /// t3 2-�
2 C
Assessor's Tax Parcel Number(s): 32— i 5 3 i'
Leal.Description:
PERMIT DESCRIPTION: AV( /en' t/ ,;au,�c---
i
[b Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: t , r %-777 -L- Applicant:
Phone: _i6—c/5-- "Fax: Phone: Fax:
Address: � Address:
oe u.4, t//// /,dam
City State Zip Code City State Zip Code
❑ Contractor: epz4;L'e "l ❑ Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City State Zip Code City / // State Zip Code
WA State Contractor License #: Contact: {/ �`«<
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: g DIMENSIONS: ` X-30 #OF STORIES:
MAIN FLOOR.TO SQ.FTG: . Nu_FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG: GARAGE SQ. FTG: DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: CONSTRUCTION TYPE: SOURCE:
I ''tC%� ,fLac
#OF BEDROOMS: TOTAL HABITABLE SPACE: IMPERVIOUS SURFACE AREA:
COST OF PROJECT: 30% SLOPES ON PROPERTY: SEWER OR ON-SITE SEPTIC.
A.1/4-- 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
Plans Examiner: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City State Zip
SPECIAL INSPECTIONS
n BOLTING ❑ CONCRETE ❑ REINFORCEMENT ❑ WELDING
Firm Name: Phone: Fax:
Inspector(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' re jhre p perty owner.
Print Name /evfr/( Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
i
AN
PLUMBING PERMIT APPLICATION Community Development Department
IllpBuilding Division
Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106
diVi]iey For Inspections, Call 688-0054 Spokane Valley, WA 99206
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Project Address: //�0 Cr Permit Use:
• Owner: , 04-1-Y) G- / Phone (Daytime Contact): K—/
Mailing Address: 1,719 KGLG (/ � id q IY1.�U,6
CitV tate 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' 1 X ` ' $6.00 = G s
2 URINALS i _X $6.00 = / _
3 TUBS • 1 X $6.00 = • •G Oz.
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 = / 010X-RAY,FOOD,.PREP/CULINARY MEAT _ C�
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 BREAIEER,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 DISPOSAUSYS X $20.00 = —
INDUSTRIAL WASTE
22 INTERCEPTOR X $15.00 =
SUBTOTAL t q
METHOD OF PAYMEN .
PROCESSING FEE
0 CASH CHECK 0 VISA 0 MASTERCARD .$35.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE: 53 `n'
•
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: 17, _.
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This site plan is being submitted for the purpose of PLANNING DEPT. APPROVED
obtaining a buiidin, •-mit d is a true and correct
representation of pro ,sal. All known property
lines/dimensions • li S,structures and easements BY• --
(:<-- A
haw been •ed) ed.„•PPPPso indicated are wetlands, } 4
bodies of wa , ste slopes or other critical areas.
Signed:
/' Z— dr .� as c
Date: '