HomeMy WebLinkAbout2004, 05-15 Permit App: BLD-04-04357 Residence STAane
Milley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
11707East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone:(509)688-0036 Fax(509)688-0037
REQUIRED SITE INFORMATION
STREET ADDRESS: /t �5 £ ' •`J 7 T7-1.
ASSESSOR'S TAX PARCEL NUMBER(S):
LEGAL DISCRIPTION: ,/ I �✓��C—crx 1
TE
1 i�;K RIb«
PER DESCRIPTION:
MIMING PERMIT Q CHANGE IN USE --0 GRADIN - -- -C]MANUFAC." ORMD HOME - -
LZ RELOCATION Li SIGN Q TENANT QOTHER
1 OWNER /APPLICANT INFORMATION
0 OWNER: 0 APPLICANT:
PHONE: FAX: PHONE: FAX
ADDRESS: ADDRESS:
—
CITY,ST• E,ZIP CITY,STATE,ZIP
®CONTRACTO-7 141.../4 ' u4 0 ARCHITECT:
PHONE", AA'- ing' # an • 21) PHONE: FAX:
ADDRESS: , _AIL 4i..I4 ,0 ADDRESS:
/,1,C ,irATE,ZIP CITY,STATE.ZIP
WA ST CONTRACTOR LICENSE1......E*4.1...F.04.--irps CONTACT:
PERMIT/BUILDING INFORMATION
COST OF PROJECT: 30%SLOPES ON PROPERTY: iki ONE MAIN FLOOR SQ Fr: 517,2
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT:_11 —
BUILDING DIMENSIONS, 7'i(iii,.ii
CONSTRUCTION TYPE: UNFIN BASEMENT: c/-I _I
NUMBER OF STORIES: STRUCTURES ON PROPERTY: 0 FINISHED BASEMENT:_d
NUMBER of BEDROOMS: 3 CRITICAL AREAS: GARAGE: 60 iq
Q,
FLANKING SETBACK: CURRENT PROPERTY SIZE: l_/O 91-7-- COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE:V A1- DECK:
REAR SETBACK: CURRENT SEPTIC USE: 10/Ti
LEFT SETBACK: CURRENT WELL USE: ft. i"A-
RIGHT
f
RIGHT SETBACK: IMPERVIOUS SURFACE AREA: </i).I T
i ,
Sp e .
,.,,,e0Mley
• PLUMBING PERMIT APPLICATION
PROJECTfi 9J PERMIT
ir--? 1 ADDRESS: J / ' USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS:
(street) city/state) (ziP)
CTOR: / LICENSE#:
imPI,Al
MAI/ ADDRESS: ONE It . T
170;,
/1! " (sfreet) f� bb�� ( ylstate) (vr)
PLUMDIN0'FIXTURES• _
DESCRIPTION DETAILS #OF UNITS X CO EQUALS. • AMOUNT
1 TOILETS • WATER CLOSET,BIDETS ----S-- X $6 se -
2 URINALS • X $6 =
3 TUBS — / X $6 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT ,--- X $6 =
5 SINKS LAVS/BASINS,BAR,FLOOR, X $6
KITCHEN,LAUNDRY,UTIUTY,
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CULINARY/MEAT =
6 DISHWASHER X $6 =
7 CLOTHES WASHER / _ X $6 =
8 GARBAGE DISPOSAL / * X $6 =
9 WATER SOFTENER X $6 =
10 ELEC HOT WATER TANK NOTE:IF GAS SEE MECHANICAL X $6 =
11 FLOOR DRAINS AREA.CASE,COIL,TRENCH, $6
CONDENSATE / X `
12 FOUNTAINS,DRINKING X $6 =
13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION, X $6
WASTE,VENT, REPAIR,REVERSALS
. PLUMBING REVERSAL •
14 SEWAGE EJECTOR GRINDER,SUMP PUMP X. $6
15 WATER USING DEVICE ICE AND/OR COFFEE MAKER X $6
HOSE BIB,STEAMER,PROOFER, n
CARBONATOR,SWAMP COOLER ✓�j -
_
16 CROSS CONNECTION VACUUM BREAKER,CHECK • N. X $6
DEVICE VALVE,AND R.P.B.P.D.FOR:
VATS,SUMPS,TANKS,BOILERS
17 SPRINKLER SYSTEM / X
18 INTERCEPTORS GREASE TRAP,SAND TRAP, • $6
CHEMICAL HOLDING TANK X • •
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6
25
20 MISC PLUMBING FIXTURE X $6 =
SUBTOTAL
0 CASH 0 CHECK d-- 0 -_ ' ' PLUS PROCESSING
FAXED PERMITS WILL ONLY BE ACCEPTED 711Th PAYkE.NT FEE
OFA MAJOR.CREDIT CARD
• TOTAL PERMIT FEE
• DUE 1
DATE: -
$ANKCARD_ UMBER: -
AUTHORIZED SIGNATURE:
S :Wa ne '
......01F Valley
MECHANICAL PERMIT APPLICATION
PADDRESS: ir..
� 16
7 T PERMITSEE
USE:
PHONE(Daytime Contact):
MAILING ADDRESS:
• (street) (city/state) •(ziP)
CONTRA (OR fj.4elt,Z11, fr• '
MAILING ADI SS: • PHONE IP:
q64 _ 1465-
1-1-014q (.,f' -
991D7
(street) (city/state) (zip)
DESCRIPTION OF WORK #.rwars X COST EQUALS AMOUNT
I FUEL BURNING APPLIANCE -OR<100,000 l X $15 =
2 FUEL BURNING APPLIANCE - - . >t00,000 - -- X -$19
3 UNLISTED APPLIANCE(ADDITIONAL FEE) -OR400,000 X $50 - _
4 UNLISTED APPLIANCE(ADOITIONAL FEE) >400,000 X $100 I.
5 USED APPLIANCE(WSEC min.AFUE noting =OR400,000 l X $50 -
6 USED APPLIANCE(WSEC min.AFUE nom) >400,000 X
$100 =
7 BOILER/REFRIGERATION 1-100M BTU X $15 - o•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 8TU X $95 =
12 GAS LOGS GAS INSERT,GAS FIREPLACE - / X $10 =
13 RANGE - X $10 =
•
14 DRYER l X $10
15 FUEL BURNING WATER HEATER - j X $10 =
16 MISCELLANEOUS FUEL BURNING APPL - - X $10 =
• 17 GAS PIPING(ea.Outlet) v - �itj 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 du ng) >10,000CFM X $19 -
22 EVAPORATIVE COOLERS - X $10 =
23 TYPE I H000 - 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 i20 -
27 AIR CONDITIONER 15-30 TON •. X $25 a
28 MR CONDITIONER 30-50 TON X $35 -
29 AIR CONDITIONER
+SOTON )( $60 •
30 LPG STORAGE TANK • - - X ...4..•,-. a10 -- - .
31 WOOD OR PELLET STOVE/INSERT - X -. $10 -
32 WOOD STOVE-FREE STANDING . - _[.. ._.-,___ ••
•
•
SUBTOTAL
o CASH 0 CHECK 0 .- 0 --- PLUS PROCESSING
FAXED PERM'S VIII.OM.YDEACCEPTED WTPHPAWIENr $35.00
OFAMAJOR CREDIT CARD FEE
. TOTAL PERMIT FEE
•
DATE: • EXPIRES: DUE
•
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: 1T9---
- ..
r .;.a t7yx. -
•
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1 Patio 1 2
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o1 41.5' 0
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44 g Gas/Elect , , 'v—_ . 4—
a °
a I e a a ° 4 .
Property Line-1 5'from center of road — —
312.43' 37TH LANE
S 89'45'35-E
LEXINGTON HOMES
12815 E. 37TH
()
PINE ROCK RIDGE 1ST ADDITION
LOT 11 BLOCK 1
Founded 1946
0 10 20 40
�� ® impson Engineers, Inc.
MIIIIIIMIIIIMIll
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
SEPTEMBER 2003 PHONE (509) 926-1322 FAX (509) 926-1323