2007, 08-22 Permit App: 07003226 Residence Project Number: 07003226 Inv: 1 Application Date: 8/22/2007 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE FAMILY RESIDENCE-SEWER Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E.SECRETARIAT
C-S-Z: VERADALE,WA 99037
Setbacks:Front Left: Right: Rear: Phone: (509)922-4297
Group Name:
Site Information: Project Name:
:i:,<.,,{=:P>fi?:+"c fz. .,A:"t'riv",:°:r#.s+'e ,IIa'+%a'M51f {'.. ,n c5fi +d."+4'....#' od"n..e- .ar,. »-' a" k•aU:kk,.'A„r •3+: .ae#vd.`2:.: ;. +fix,<;fi:n ti .a, *'...
Plat Key: Name: Range District: Sout
Parcel Number: 45342.3515 Block: Lot:
SiteAddress: 13002 E 39TH LN Owner:Name: SCHMITZ,CLIFFORD M&MARG
Address: 16520 E SECRETARIAT LN
Location::CSV VERADALE,WA 99037-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: iti.%_-tt,.%',.....,,ASEAVAPIAMTLI, -ter _ aZilta-,,,W 4 4 a *<t, .. , a +mow _ _ _.
Review
Building Plan Review Released By:
Originally Released: 8/21/2007 By: TMELBOU
Landuse/Zoning/HE Conditions Released By:
Originally Released: 8/20/2007 By: cjjanssen
Sewer Review [Released By:
Originally Released: 8/22/2007 By: JLMain
Permits: �m . ;�-
Operator: jmm Printed By: jmm Print Date: 8/22/2007
Project Number: 07003226 Inv: 1 Application Date: 8/16/2007 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE FAMILY RESIDENCE-SEWER Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E.SECRETARIAT
C-S-Z: VERADALE,WA 99037
Setbacks:Front Left: Right: Rear: Phone: (509)922-4297
Group Name:
Project Name:
Site Information:
Plat Key: Name: Range District: Sout
Parcel Number: 45342.3515 Block: Lot:
SiteAddress: 13002 E 39TH LN Owner:Name: SCHMITZ,CLIFFORD M&MARG
Address: 16520 E SECRETARIAT LN
Location::CSV VERADALE,WA 99037-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review In formation: .ate ., _ me
Review
BuildingPlan Review1
Released'Bj�:' j 24 -a `
Landuse/Zonin E Conditions4
ReIca ld'a
Sewer Review Released By:
Permits: 31444,44F..a. ...: , ._.E u .; 47 ,. r - ;
Operator: jmm Printed By: jmm Print Date: 8/16/2007
Project Number: 07003226 Inv: 1 Application Date: 8/22/2007 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB 1,449 $132,380.64 1,449 $132,380.64
2ND FLOOR R-3 VB 647 $48,317.96 647 $48,317.96
BASEMENT U R-3 VB 1,449 $21,735.00 1,449 $21,735.00
COV DECK R-3 VB 150 $2,250.00 150 $2,250.00
DECK OPEN R-3 VB 186 $2,790.00 186 $2,790.00
GARAGE U-1 VB 708 $13,452.00 708 $13,452.00
Totals: 4,589 $220,925.60 4,589 $220,925.60
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,671.35
WSBC SURCHARGE 1 SELECT $4.50
SF PLNS RVW<7999 SQ FT 1 SELECT $668.54
Permit Total Fees: $2,344.39
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509)325-4505
SPOKANE,WA 99202
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 5 NUMBER OF $50.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $95.00
Operator: jmm Printed By: jmm Print Date: 8/22/2007
Project Number: 07003226 Inv: 1 Application Date: 8/16/2007 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB / ei .1.01-113- $129,639.84 1,419 $129,639.84
2ND FLOOR R-3 VB 6 i 7 --99T $44,135.88 591 $44,135.88
BASEMENT U R-3 VB /`I"4`1 J,4+9 $21,285.00 1,419 $21,285.00
DECK QPEN 3 )6I 4-30- $1,950.00 130 $1,950.00
r�,t, AUL -� r L I St
GARAGE U-1 VB e 708 $13,452.00 708 $13,452.00
Totals: .41-2 67— $210,462.72 4,267 $210,462.72
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,615.35
WSBC SURCHARGE 1 SELECT $4.50
SF PLNS RVW<7999 SQ FT 1 SELECT $646.14
Permit Total Fees: $2,265.99
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509)325-4505
SPOKANE,WA 99202
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 5 NUMBER OF $50.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $95.00
Operator: jmm Printed By: jmm Print Date: 8/16/2007
, Project Number: 07003226 Inv: 1 Application Date: 8/22/2007 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: LIGHTNING MECHANICAL INC Firm: LIGHTNING MECHANICAL INC
Address: 7110 E 6TH AVE Phone: (509)533-9089
SPOKANE VALLEY WA 99212
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 3 NUMBER OF $18.00
SINKS 6 NUMBER OF $36.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
MISCELLANEOUS FIXTURES 3 NUMBER OF $18.00
Permit Total Fees: $114.00
Payment Summa
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $2,344.39 $2,344.39 $0.00 $2,344.39
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $114.00 $114.00 $0.00 $114.00
$2,553.39 $2,553.39 $0.00 $2,553.39
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: jmm Printed By: jmm Print Date: 8/22/2007
Project Number: 07003226 Inv: 1 Application Date: 8/16/2007 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Building Permit
Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO
Address: 16520 E SECRETARIAT Phone: (509)922-4297
VERADALE WA 99037
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
1&2 FAMILY R-3 VB 1,419 $129,639.84 1,419 $129,639.84
2ND FLOOR R-3 VB 591 $44,135.88 591 $44,135.88
BASEMENT U R-3 VB 1,419 $21,285.00 1,419 $21,285.00
DECK OPEN R-3 VB 130 $1,950.00 130 $1,950.00
GARAGE U-1 VB 708 $13,452.00 708 $13,452.00
Totals: 4,267 $210,462.72 4,267 $210,462.72
Item Description Units Unit Desc Fee Amount
RESIDENTIAL PERMIT FEE 1 SELECT $1,615.35
WSBC SURCHARGE 1 SELECT $4.50
SF PLNS RVW<7999 SQ FT 1 SELECT $646.14
Permit Total Fees: $2,265.99
Mechanical Permit
Contractor: STURM HEATING Firm: STURM HEATING
Address: 1112 N NELSON Phone: (509)325-4505
SPOKANE,WA 99202
Item Description Units Unit Desc Fee Amount
GAS WATER HEATER 1 NUMBER OF $10.00
GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00
GAS PIPING 3 #OF UNITS $3.00
VENTILATING FANS 5 NUMBER OF $50.00
GAS LOG OR GAS INSERT 1 NUMBER OF $10.00
HOOD-TYPE II 1 NUMBER OF $10.00
Permit Total Fees: $95.00
Operator: jmm Printed By: jmm Print Date: 8/16/2007
Project Number: 07003226 Inv: 1 Application Date: 8/16/2007 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: LIGHTNING MECHANICAL INC Firm: LIGHTNING MECHANICAL INC
Address: 7110 E 6TH AVE Phone: (509)533-9089
SPOKANE VALLEY WA 99212
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 3 NUMBER OF $18.00
SINKS 6 NUMBER OF $36.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
MISCELLANEOUS FIXTURES 3 NUMBER OF $18.00
Permit Total Fees: $114.00
Pa ment Summa
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Building Permit $2,265.99 $2,265.99 $0.00 $2,265.99
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $114.00 $114.00 $0.00 $114.00
$2,474.99 $2,474.99 $0.00 $2,474.99
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: jmm Printed By: jmm Print Date: 8/16/2007
Project Number: " 07003226 Inv: 1 Application Date: 8/16/2007 Page 1 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: SINGLE FAMILY RESIDENCE-SEWER Contact: CLIFF SCHMITZ CONSTRUCTION
Address: 16520 E.SECRETARIAT
C-S-Z: VERADALE,WA 99037
Setbacks:Front Left: Right: Rear: Phone: (509)922-4297
Group Name:
Site Information: Project Name:
Plat Key: Name: Range District: Sout
Parcel Number: 45342.3515 Block: Lot:
SiteAddress: 13002 E 39TH LN Owner:Name: SCHMITZ,CLIFFORD M&MARG
Address: 16520 E SECRETARIAT LN
Location::CSV VERADALE,WA 99037-
Zoning: UR-3.5 Urban Residential 3.5
Water District: Hold: ❑
Area: .00 Acres Width: 0 Depth: 0 Right Of Way(ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: :� .,:w, x ; N
Review
Building Plan Revieweerie Bg € >� ; : =
Landuse/Zoning/HE Conditions Iel "
Sewer Review
Permits: ®.� ..� , . �.� .. , . �x .. �u,.
Operator: jmm Printed By: jmm Print Date: 8/16/2007
Project Number: 07003226 Inv: 1 Application Date: 8/16/2007 Page 3 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Plumbing Permit
Contractor: LIGHTNING MECHANICAL INC Firm: LIGHTNING MECHANICAL INC
Address: 7110 E 6TH AVE Phone: (509)533-9089
SPOKANE VALLEY WA 99212
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 3 NUMBER OF $18.00
SINKS 6 NUMBER OF $36.00
SHOWERS 1 NUMBER OF $6.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
GARBAGE DISPOSAL 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
FLOOR DRAINS 1 NUMBER OF $6.00
MISCELLANEOUS FIXTURES 3 NUMBER OF $18.00
Permit Total Fees: $114.00
Pa ment Summa
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing '_
Building Permit $2,265.99 $2,265.99 $0.00 $2,265.99
Mechanical Permit $95.00 $95.00 $0.00 $95.00
Plumbing Permit $114.00 $114.00 $0.00 $114.00
$2,474.99 $2,474.99 $0.00 $2,474.99
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: jmm Printed By: jmm Print Date: 8/16/2007
Project New project 0
Previouspre-app meeting ❑
.61"pc'I Ile Transmittal Plan revisions
City of Spokane Valley Transmittal Date:
400°
Community Development Tuesday,August21,2007
Department
11703 E.Sprague Ave,Suite B3
Spokane Valley,WA 99206
Phone:509.688.0036
Site Address: 13002 E 39TH LN Project Number: 07003226
Parcel Number: 45342.3515
Zoning: UR-3.5 Water District:
Fire District: FD 01
Applicant: CLIFF SCHMITZ CONSTRUCTION Owner: SCHMITZ, CLIFFORD M & MARGO
16520 E. SECRETARIAT 16520 E SECRETARIAT LN
VERADALE, WA 99037 VERADALE, WA 99037-
(509) 922-4297
e-mail: CLIFFS@CET.COM e-mail:
Contact: CLIFF SCHMITZ CONSTRUCTION Occupant:
16520 E. SECRETARIAT
VERADALE, WA 99037 e-mail:
(509) 922-4297
e-mail: CLIFFS aeCET.COM
Contractor: CLIFF SCHMITZ CONSTRUCTION Arch/Engineer:
16520 E SECRETARIAT
VERADALE WA 99037
(509) 922-4297
e-mail:
Project SINGLE FAMILY RESIDENCE-SEWER
Description:
Building Landuse Engineer Utilities Health Fire Dist Assessor
REVISED SITE PLAN
Please send all plan review and project comments via e-mail to the
highlighted individuals.
ProjectNew project
Previous pre-app meeting
'Sfii aka
0 ne
Transmittal Plan revisions
Cita of Spokane Valley Transmittal Date:
4011000 Valley
Community
Development Thursday,August 16,2007
Department
11703 E.Sprague Ave,Suite B3
Spokane Valley,WA 99206
Phone: 509.688.0036
Site Address: 13002 E 39TH LN Project Number: 07003226
Parcel Number: 45342.3515
Zoning: UR-3.5 Water District:
Fire District: FD 01
Applicant: CLIFF SCHMITZ CONSTRUCTION Owner: SCHMITZ, CLIFFORD M & MARGO
16520 E. SECRETARIAT 16520 E SECRETARIAT LN
VERADALE, WA 99037 VERADALE, WA 99037-
(509) 922-4297
e-mail: CLIFFS@CET.COM e-mail:
Contact: CLIFF SCHMITZ CONSTRUCTION Occupant:
16520 E. SECRETARIAT
e-mail:
VERADALE, WA 99037
(509) 922-4297
e-mail: CLIFFSaCET.COM
Contractor: CLIFF SCHMITZ CONSTRUCTION Arch/Engineer:
16520 E SECRETARIAT
VERADALE WA 99037
(509) 922-4297
e-mail:
Project SINGLE FAMILY RESIDENCE-SEWER
Description:
Building Landuse Engineer Utilities Health Fire Dist Assessor
APPLICATION
CONSTRUCTION PLANE 1
SITE PLANE
REV SIGN OFF
CJ
Please send all plan review and project comments via e-mail to the
highlighted individuals.
New project � .
• io."9\iftk, Project Previous pre-app meeting 0
nooliane CITY or-.
Transmittal
Plan revisions D
City of Spokane Valley Transmittal Date:
4.0,00Valley
Community Development Thursday,August 16,2007
Department
11703 E.Sprague Ave,Suite B3
Spokane Valley,WA 99206
Phone: 509.688.0036
Site Address: 13002 E 39TH LN Project Number: 07003226
Parcel Number: 45342.3515
Zoning: UR-3.5 Water District:
Fire District: FD 01
Applicant: CLIFF SCHMITZ CONSTRUCTION Owner: SCHMITZ, CLIFFORD M & MARGO
16520 E. SECRETARIAT 16520 E SECRETARIAT LN
VERADALE, WA 99037 VERADALE, WA 99037-
(509) 922-4297
e-mail: CLIFFS@CET.COM e-mail:
Contact: CLIFF SCHMITZ CONSTRUCTION Occupant:
16520 E. SECRETARIAT e-mail:
VERADALE, WA 99037 nn ��7
(509) 922-4297 RECE tl V E D
e-mail: CLIFFSeCET.COM
Contractor: CLIFF SCHMITZ CONSTRUCTION Arch/Engineer: AUG 1 r7
16520 E SECRETARIAT
VERADALE WA 99037 fl fl l D ,
(509) 922-4297 lJ
e-mail:
Project SINGLE FAMILY RESIDENCE-SEWER
Description:
Building Landuse Engineer Utilities Health Fire Dist Assessor
APPLICATION
CONSTRUCTION PLANS
SITE PLANS
REV SIGN OFF
Please send all plan review and project comments via e-mail to the
highlighted individuals.
Permit Center RECEIVED BY
StiePERMIT NUN0BER7"3 lz
11707 E Sprague 4t3Tri liteSI KANE VALLEY
��e Spokane Valley,WA 99206 PERMIT FEE:
.000
Valley (509)688-0036 FAX:(50 8 (67 2007
Community Development www.spokane valley.orz.com
PERMIT CENT
WA-
Residential Construction ew Construction ❑ Accessory Bldg
Permit Application o Addition/Remodel o Deck
o Other:
SITE ADDRESS ! -S O OZ, r , J / n',,' �; 4C - __ -- LEGAL DESCRIPTION: LOT /S. 134 K3 Ppueleo s "`Dce3
ASSESSORS PARCEL NO: 4 J , 41 �'/
Building owner _ �y,�,,,
Contractor. - _:
Name: c�
Name: C I P r=' S GI7 i • I TZ Coil ST. J
Address: / i'5 Z O • 5 T
Address: Zip: f��3.7
City: U eft 1)- -- -
City: Zip: Q �
Phone: g999933 Fax: $-7 I-g 7 I
Phone: Fax:
Lic No: Exp.Date:
Contact Person City Business Lic No:
Name: L L. I F I'` S e.h'Irf\—
Phone: cp...-7-7 3
Describe the scope ofCost of Project:
work in detail: I $ ,2 05' 000 I
1
MPAA1 eS1cPJC� .
**************The following MUST be complete: (write N/A if not applicable)**********************
#OF STORIES: TOTAL HABITABLE SPAS
HEIGHT T2-1 DIMENSIONS:6 3.S"(I)
FLOOR TO SQ. 2 FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
MAIN (�Q p� r AREA:
FTG: 1 L) f_1 c r- �r I 1 Ci-7 '7 A. -
FINISHED BASEMENT GARAC SQ„,FTG: DEC ' OV. PATIO •Q. FTG: 30%
SLOPES ON
GI's /�� . • ism
SQ. FTG: -PJ SEWER OR SEPTIC?
#OF BEDROOMS: CONSTRUCTION3 hoTYPE: 6 Sec 4Z
DISCLAIMER
i�
The LAIMee verifies,acknowledges and agrees by their signature that 1) If this permit is for construction of or on a dwelling,the
dwelling is/willistbe servedby potable oor has permission orepresent rship fhis City of Spokane the property owner Valley
Iths transaction. 4)it inure to the property owner. 3) The
All construction is to be done
signatory is the property
Sfull compliancewith rit Center.he City 5) This City of Spokanf Spokane Valley e Valley Permit isment Code. not a permit orapp oval available for review at the City of violation of federal,state or
Spokane ,Valley P
local laws,codes or ordinances.6 PI. s or .dditional information may be required to be submitted,and subsequently approved before
this application can b- p • -.se•, j
'� Date e-,,---61")Signature _ �� -.�=���
Method of Payme • ,axed permit.••tications will only a acceptedd with major bba 0VISA ) ❑ Other
❑ Cash 0 Check
Bankcard#: VIN#:
Expires:
Authorized Signature:
REVISED 8252005
u ,..-TA c_u::.-i.,c,../1..1.11Z,IUD LRMt I CJS f iZ
- - I
Y ;F Spokane-Valley,w A °4206 f
( 09)588-0036 FAX:(509)655-00 7 pE
ConanimityD-_veloPMET,t :.5'.;,i._. k�,�a;=.".o,o RECEIVED : ?E r FEE:
Plumbing Permit A lication T
S ADDFF'S_ I So02Z L. 3 4i' AUG 16 2001
BuildingOwner PRMIT.GENTE-
. - - ar --
Add"'css: City= Slate: Zip:
Contractor 1.16 H 7t,1t 6 C.1-1- O -+ _
Nam: Phone_ Fax: I
Address: City: Staff Zip:
License No: City Business Lin:
i
Contact
;varve: Phone
DESCRIPTION OF WORK S OF UNITS X COST _ = I TOTAL AMOUNT
I
1 TOILETS WATER CLOSET,BIDETS 3 X £6.00 =
2 URINALS X $6.00 =
3 TUBSX S6.00 =
4 SHOWERS(PER TRAP) BATH.STALL.ONSITE BUILT L X S6.0D =
LAVS/BASINS•BAR FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, / _ X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT (� _
6 DISHWASHER — X "Op =
7 CLOTHES WASHER X S6.DO =
8 GARBAGE DISPOSAL j X $6.00 =
9 WA I tK SOFTENERX S6.DD =
F
70 - Fl Ci RIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X I $6_DD =
AREA.CASE,COIL,TRENCH, -
11 FLOOR DRAINS CONDENSATE I X 56-00 = 1
12 ROOF DRAINS/OVERFLOW DRAINS _ X S6.00 =
13 FOUNTAINS,DRINKING _ X 5,6.00 = I
WA i tK PIPING/DRAIN-IN WASTE. NSTALLATION,ALTERATION,REPAIR,
14 VENT.PLUMBING,REVERSAL REVERSALS X $6.00 `= _,
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6_DD =
ICE AN/OR COIt- E MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER ......3 X $6.00 =
PROOFER,CARBONATOR,SWAMP
COOLER
VACUUM BREAKER,CHECK VALVE,
AND RP_B_P.D.FOR: VATS.TANKS,
17 CROSS CONNECTION DEVICE BOILERS _ X 1 56.00 f =
GREASE TRAP,SAND TRAP,
18 INTERCEP I ORS CHEMICAL HOLDING TANK X $6.00 =
19 MEDICAL GAS(per outlet) NITROUS.OXYGEN X $6.0D =
2D MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
21 PRIVATE SEWAGE DISPOSALUSYS X S2D.00 =
22 INDUSTRIAL WASTE INTERCEPTOR __ X 515.00 _ =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
DCASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00
Card# VIN: TOTAL PERMIT I-ht.DUE:
AUMIORIZED SIGNATURE:
REVISE sagas
SV5-r,tie 11707 E Sprague Ave,Suite 106 PERMIT N-U �3ER
tSc�t=Fya Spokane Valley,WA 9'0206 ECEIVED BY _
2,,, Valley FAX (609)688-0037 ROF SPOKp,NE VAL PENT FEE
Co-.u-nuniry velopment u�t^v.spokane-,'ailev.ars
Mechanical Permit Application a r i l Residential -
STrE ADDRESS-_ ( "2)l)O?_, A 41CEN I tR
PERMIT.. ::_:
BuilcEng OOene
Name:
,..._- one: Fax:
City State: Zip:
Address: .
Contra cter• -( rr i VI
h
Phone: Fax
Nares
City: State: Zip:
Address:
License No: City Business Lie:
Contacf --.
-.. . -_. .. -• Phone
Name:
DESCRIPTION OF WORK #OF UNITS X COST = ' TOTAL AMOUNT
Equal to or less than 100,000 1 X 512.00 =
1 FUEL BURNING APPLIANCE X $15.00 =
2 FUEL BURNING APPLIANCE More than 100,000
3 UNLIS I tU APPLIANCE(Additional Fee) - Equal to or less than 400,000
X $50.00 =
X $100.00 =
4 UNLISTED APPLIANCE(Additional Fee) More than 400,000X $50.00 =
5 USED APPLIANCE(WSEC min.AFUE rating) Equal to or less than 400.000
6 USED APPLIANCE(WSEC min.AFUE rating) More than 400,000 X $100.00 =
1-IDDM BTU X $12.00 =
7 BOILER/REFRIGERATION _
B BOILER REFRIGERATION 101-50DM BTU X $20.00 =
501-1,000M BTU
9 BOILER/REFRIGERATION . X $25.00 =
1,001-1,750M BTU X $35.00 =
10 BOILEPJREFR{GEP.ATION
More than 1,750M BTU X $60.00 =
11 � BOILER/REFRIGERATION
12 I GAS LOG,GAS INSERT,GAS FIREPLACE
X $10.00 =
)( $10.00
13 RANGE
X $10-00 =
14 DRYER
X $10.00 _
15 FUEL BURNING WATER HEATER I X $10.00 =
16 MISC.FUEL BURNING APPLIANCE
X $1.OD _
17 GAS PIPING(each outlet)
X $10.00 -
_
18 DUCT SYSTEMS
s X $10.00 _-
19 1 VENTILATING FANS =
Equal to or less than 10,000 CFM X $12.00
2D AIR HANDLER(DOES NOT include ducting) q _
(DOES NOT include ducting) Greater than 10.000 CFM X $15.00 =
- 21 AIR HANDLER 9) $10.00 -
22 EVAPORATIVE COOLERS _ X =
X $50.00 -
23 TYPE I HOOD
X $10.00 _
24 TYPE II HOOD $1200 =
25 HEAT PUMP/AIR CONDITIONER 03 X .
TON -=
3-15 TON X $20.00 =
26 AIR CONDITIONER
15-30 TON X $25.00 =
27 AIR CONDITIONER
30-50 TON X I $35.00 =
28 AIR CONDffiONER _
29 AIR CONDii10NER
More than 50 TON X $60.00 -
X £10.00 =
30 LPG STORAGE TANK .00 _
-
31 WOOD OR PELLET STOVEJINSERT X $X $1010.00 =
32 WOOD STOVE-FREE STANDING X $15.0025 =
33 REPAIR&ADDITIONS X $12.00 =
34 VENTILATION SYSTEMS X $12.00 =
35 VENTILATION MECHANICAL EXHAUST x $12.00 =
35 INCINERATOR-RESIDENCE x $19.00 =
37 INCINERATOR-COMMERCIAL SUBTOTAL
METHOD OF PAYMENT:
EXPIRES: PROCESSING FEE $35.00
DCASH CICHECK CIVISA D MG
VIN: TOTAL PERMIT FEE DUE:
CARD r
AUTHORIZED SIGNATURE:
REVISED 626/05
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