2004, 06-30 Permit App: BLD-04-04842 Residence , spian,dre‘..
4.000Valley PERMIT APPLICATION WORK SHEET
SPOKANE VALLEY COMMUNITY DEVELOPMENT
BUILDING DIVISION
117O7East Sprague Ave Ste 106
Spokane Valley, WA 99206
Phone:(509)688-0036FaJC150916880037
REQUIRED SITE INFORMATION
STREET ADDRESS: 1 0041 e, "3--h
E)SESSOR'S
TAX PARCEL NUMBER(S): 2- ,-- � ok, ‘AA
LEGAL DISCRIPTION: I.-07 Cit 6(7;
PER 1T DESCRIPTION:
UIL.DING PERMIT El CHANGE IN USE 0 GRADING 0 MANUFACTU KZD HOME
RELOCATION Li SIGN O TENANT 0 OTHER
1 W OWNER / APPLICANT INFORMATION
0 OWNER: 0 APPLICANT:
PHONE FAX: PHONE: FAX:
..- ADDRESS: ADDRESS:
l j , • C`IT�Y,ST• E,ZIP C..4CITY,STATE,ZIP
CONTRACT•-1 14L. 1�� , ® ARCHITECT: [
PHONE`.'/ ./.." eM 1 i • PHONE: V--- -2-
FArZi
ADDRESS: -at a,...1 `1--- ADDRESS: 131t
ca ,$TATE,ZIP p CITY,STATE,ZIP
cel GIA
WA ST CONTRACTOR LICENSE#f ` ,t CONTACT: Z
X 1"7 ►� Ps
P
PERMIT/BUILDING INFORMATION
n( `
COST OF PROJECT: 30%SLOPES ON PROPERTY: j'_ MAIN FLOOR SQ FT: 1 L3
BUILDING HEIGHT TO PEAK: OCCUPANCY GROUP: 2ND FLOOR SQ FT:
BUILDING DIMENSIONS: CONSTRUCTION TYPE: UNFIN BASEMENT: )(-1 I
NUMBER OF STORIES: I STRUCTURES ON PROPERTY: 1l)0 FINISHED BASEMENT:3 5 0
NUMBER of BEDROOMS: 2- CRITICAL AREAS: " GARAGE: c-L
FLANKING SETBACK: &RENT PROPERTY SIZE: t )5q COVERED DECK:
FRONT SETBACK: CURRENT PROPERTY USE: U( t A Nr DECK:
`
' REAR SETBACK: CURRENT SEPTIC USE: t'f f1 o nO = \ GT')
jF
LEFT SETBACK: CURRENT WELL USE: ki i nA
RIGHT SETBACK: IMPERVIOUS SURFACE AREA: L621 5F-
s
MANUFACTURED HOME SIGN 1
WIDTH: LENGTH: SQ FT OF SIGN: HEIGHT OF SIGN:
Offt
YEAR: PIT SET: #OF SIGNS: AREA OF EXIST SIGN:
MANUFACTURER: TYPE OF SIGN:
IRELOCATION FIRE SAFETY
PREVIOUS ADDRESS: FIRE SPRINKLER: i FIREAI_ARM:
PAINT BOOTH: ' TENT:
PROPOSED USE: FIREWORKS DISPLAY:
BLASTING: DATE/TIME:
IWA STATE NON—RESIDENTIAL ENERGY CODE
PLANS EXAMINER: PHONE: FAX: -
ADDRESS:
CITY,STATE,ZIP
INSPECTOR: PHONE: FAX:
ADDRESS:
CITY,STATE,ZIP
SPECIAL INSPECTIONS
❑ BOLTING CICONCRETE ® REINFORCEMENT 0 WELDING
FIRM NAME: PHONE: FAX:
INSPECTOR(S):
BUILDING STAFF USE ONLY
•IS PUBLIC SEWER AVAILABLE: CI YES CI NO IF YES: CI COUNTY 0 CITY -
IS PUBLIC WATER AVAILABLE: 0
YES 0 NO IF YES,WHICH WATER DIST/IRR:
IS PROPERTY LOCATED WITHIN DESIGNATED STORMWATER CONTROL AREA: 0 YES 0 NO
IS THE PROPERTY LOCATED WITHIN ASA: 0 YES 0 NO "PSSA: 0 YES Q NO
I DATE: I STAFF: = = !I,
METHOD OFPAYMENT:
0 0 T 0 11...x.
OMaStiYaei. VISA
CASH CHECK ` --_�' as11""I"
BANKCARD AE; • "
AUTHORIZED S/GNATUR . jiiiii
*FAXED PERMIT APPUCATIONS WILL ONLY BE ACCEPTED WITH MAJOR BANKCARD
1F
�p aFP e
% .i '
MECHANICAL PERMIT APPLICATION
ROJECTPERMIT
ADDRESS: I7 00 qC- 3-1 A USE:
OWNER: PHONE(Daytime Contact):
MAIUNG ADDRESS:
. (street] (city/state) /� •(zip)
CONTRI f _ ' 4 WEFJE
�-1''i — ; JDLd
MAIUNG AD6 SS: PHONE It: .. i
Li8� — 465` .
. /-1-61(1 6 • 9907
(street) (city/state) (zip)
DESCRIPTION OF WORK •orr emu X COST EQUALS AMOUNT
1 FUEL BURNING APPLIANCE I.OR<100,000 i X $15 -
2 FUEL BURNING APPLIANCE >100,000 X $19 -
3 UNUSTED APPLIANCE(ADDITIONAL FEE) -OR400,000`' X $50 - _
_ 4 UNLISTED APPLIANCE(ADDITIONAL FEE) y400,000 - X $100 -
5 USED APPUANCE(WSEC mkt.AFUE rating) -OR<400,000 X $50 -
6 USED APPUANCE(WSEC mm.AFUE seting) >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 457 =
11 BOILER/REFRIGERATION +1750M BTU X $95' -
12 GAS LOG,GAS INSERT,GAS FIREPLACE - ' X $10
13 RANGE - X $10 1 -
14 DRYER - 1 X $10
15 FUEL BURNING WATER HEATER - j X $10 =
16 MISCELLANEOUS FUEL BURNING APPL - X $10 =
17 GAS PIPING(ea.Outlet) - 2, X $1 =
18 DUCT SYSTEMS - X $10 -
19 VENTILATING FANS - 4 X $10 =
20 AIR HANDLER(DOES NOT Include ducting) -OR<10,000CFM X $12 =
21 AIR HANDLER(DOES NOT kndude ducting) >10,000CFM X $19 = •
22 EVAPORATIVE COOLERS - X $10 =
23 TYPE I HOOD f - X $50 -
24 TYPE II HOOD - I 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 6230 LPG STORAGE TANK .. - X ...?;--r-.: $104 -- - -
31 WOOD OR PELLET STOVE/INSERT - X' , $10 =
32 WOOD STOVE-FREE STANDING - X -. $25 --
- _ - - .- v SUBTOTAL
11155111: 1,t'asZkzEd
❑ CASH 0 CHECK 0 OMER 0 --i=`r' ' PLUS PROCESSING
FAXED PERMITS WRRE MAJOR
1-W, PA rrr CARDFEE . $35.00
OF A TOTAL PERMIT FEE
•
DUE
DATE: EXPIRES:
BANKCARD NUMBER: ��
--- x- - _
AUTHORIZED SIGNATURE:
Sfilkane
..0.0 Valley
• PLUMBING PERMIT APPLICATION
PROJECT PERMIT
f
ADDRESS: t 3CiO'1 C. 2 7 I� USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS: -
(street) (city/state) (zip)
C CTOR: / 19_, - LICENSE tt:
- 6188" 1
MAI 0,
ADDRESS: ONE lfi ,ii _ 4 71
/7L ,,s. in,,,,,,v,.. l���f�
(street) (city/state) (zit))
PLUM91MG FIXTURES
;F.SCRIFTION DETAILS At OF w ars X COST EQJALS " AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6 - •
2 URINALS X $6
3 TUBSX $6 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT "%) X $6
5 SINKS LAVS/BASINS,BAR,FLOOR, X $6
KITCHEN.LAUNDRY,UTILITY,
JANITOR,PHOTO,X-RAY,FOOD,
PREP/CUUNARY/MEAT
6 DISHWASHER IX $6 =
7 CLOTHES WASHER ' X $6 =
8 GARBAGE DISPOSAL I - X $b =
9 WATER SOFTENER X $6 a
10 ELEC HOT WATER TANK NOTE:IF GAS SEE MECHANICAL X $6' =
11 FLOOR DRAINS AREA,CASE,COIL TRENCH, $6
CONDENSATE I 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,
CARBONATOR,SWAMP COOLER
C
16 CROSS CONNECTION VACUUM BREAKER,CHECK X $6 •
DEVICE VALVE,AND R.P.B.P.D.FOR:
VATS,SUMPS,TANKS,BOILERS =
17 SPRINKLER SYSTEM i X $25
18 INTERCEPTORS GREASE TRAP,SAND TRAP, $6
CHEMICAL HOLDING TANK X =
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 I.
20 MISC PLUMBING FIXTURE X $6 = -
• SUBTOTAL
❑ CASH 0 CHECK ❑ 0 -' 4 ' PLUS PROCESSING 044
FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT $35.00
OF A MAJOR CREDIT CARD FEE '
TOTAL PERMIT FEE
DUE I
DATE:
•
AUTHORIZED SIGNATURE:
•
I •
.a / This site plan is being submitted for the pudpase of
/ obtaining a building permit and is a true and correct
! ! N. representation of the proposal. AN known y
' lines/dime I_ .ns,curb lines,structures and a..
,� y. / / / have flood. Also . d
. 1 . , I, / c• are
�NE . , ! •h I
�� /� . steep er~. . / . areas.
ROAD%MOTH r S-S,lgnsd: £i4L/.I.L.A
FRONTllieraigtilliai
FLAIrI !I &)S ' j ,
COMMENTS
REVIEWED IIPw1AIii9ixEL I -
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House /
/ / .
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/ Conc. / I
/ j
-_ /1/ Garage cover-. /- --
•
6-0"
,' / :Walkway' /
/' : , 6/0' r�
, -2.
Driveway ... -'\; /
/ I
-
V .s/EI- / `'` `,', \%/� / 25' Bldg
i Setbock
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�`A1(�/�` \� /� _dement
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-. \ \ • LEXINGTON HOMES\ ,
Zri.:.-7...---------7-------.. - 0 .., \\ 13009 E.37th
Property Line PINE ROCK RIDGE 1ST ADDITION
LOT 2 BLOCK 6
Founded 1946
0 10 20 40 �� t
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,,,,,,,,,1 ■„I„I `J impson Engineers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARGONNE ROAD, SPOKANE WA., 99212-2789
SEPTEMBER 2003 PHONE (509) 926-1322 FAX (509) 926.1323