2003, 06-18 Permit App BD-03-626 Residence)pokne 11707 E SPRAGUE, STE 106
0,00 Valley SPOKANE VALLEY, WA 99206
(509)688-0036 FAX (509)688-0037
PROJECT TRANSMITTAL:
TRANSMITTAL DA 1'E:
SITE INFORMATION PERMIT INFORMATION
f
Site Address: t 2 `T 5 Cc,,Y Y2
v'N
Parcel Number:
Subdivision: 1_01,0) U
Block: 3 Lot: 5--
Zoning: Water Dist:
Owner: f ct,.l d-& e,,yla
Address: 3 4 5 Ma ✓� vk
Building Inspector: -Kea .�
BUILDINGS:
Permit Number: D 03 4,Issue Date:
Permit Use: 1ae5
Applicant:
Contact:
Contractor:
Phone:
Phone:
Setbacks — Front:2Z Left:1-2_ Right 3 Rear: 37
APPROVALS
PLANNING:
ENGINEERS:
.01(s.tek @Ili 6
H:
SEWER:
5,GUIL-teX ablkfmkr-1791N ROI p_hki5A,
V004-I viC)
FIRE ST:
APPROVALS
11,6q 627-3D -
16.0-0
yoo G 14c/to
`7 GOO
(e0(0.Lio
o s2. ssa
15-2-00
t pLV-1 I.2C7
10-2,1 .
2,G44--. 2_0°20
LI '570
123o. (-(2o
METHOD 0
❑ CASH
DATE:
Spo
crrt a�
kane
.0, a..ley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: CZ 4 S. Ce, 6 1 N
PERMIT
USE:
OWNER; a A Y 0 e l� ,,,.--- j
PHONE (Daytime Contact):
MAILING ADDRESS: ^
'14�
4 S. c s % Co L Ii� C. r C r v\ �-C r 'C r
(street) (city/state) (ZIP)
CONTRACTOR: /� (] ,1
ALPR1p 1 P1u+ti- bow `j
LICENSE 4:
MAILING ADDRESS: l
PHONE it:
(street) (city/state) (Lll')
PLUMBING FIXTURES
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6
=
/.9
2
URINALS
X
$6
-
3
TUBS
X
$6
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
3
X
$6
=
f SS-
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, FOOD, PREP/CULINARY/MEAT
s
X
$6
=
O
6
DISHWASHER
/
X
$6
7
CLOTHES WASHER
/
X
$6
=
4
8
GARBAGE DISPOSAL
I
X
$6
=
j
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
=
4,
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,
S I AMER,hPROOFER, CARBONATOR,
SWAMP COOLER
2_
X
$6
=
/ '2-
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
$6
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
=
20
MISC. PLUMBING FIXTURE
X
$6
=
PAYMENT
VISAN
CHECK IS ■ E__._..._.._.... _
SUBTOTAL:
C1 L
PLUS PROCESSING FEE:
$35.
TOTAL PERMIT FEE DUE:
9-5, oc"
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
*lane
,,1 0Valley
Mechanical Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT
ADDRESS: 12 4 S . C.-
YS ; Iv
PERMTT
USE:
OWNER: Oc ni 1
,.,,`—
PHONE (Daytime Contact):
MAILING ADDRESS:
(street)
(city/state) (ZIP)
CONTRACTOR: o nn Ao ez_T
CENTI�t4 -
LICENSE #:
MAILING ADDRESS:
PHONE #:
(street)
(city/state) (ZIP)
METHOD OF PA
❑ CASH ❑ C
DESCRIPTION OF WORK
# OF UNITS
X
COST
EQUALS
AMOU
I
1
FUEL BURNING APPLIANCE
= OR < 100,000
1
X
$15
-
2
FUEL BURNING APPLIANCE
> 100,000
X
$19
=
3
UNLISTED APPLIANCE (ADDITIONAL FEE)
= OR < 400,000
X
$50
=
4
UNLISTED APPLIANCE (ADDITIONAL FEE)
> 400,000
X
$100
=
5
USED APPLIANCE (WSEC min. AFUE rating)
= or <400,000
X
$50
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
$28
=
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
-
X
$10
=
13
RANGE
-
X
$10
=
14
DRYER
-
1
X
$10
=
I 0
15
FUEL BURNING WATER HEATER
-
T
X
$10
/ U
16
MISC. FUEL BURNING APPL.
-
X
$10
-
17
GAS PIPING (ea. Outlet)
-
Z
X
Si
=
v
18
DUCT SYSTEMS
-
_t—_
X
$10
-
=,
19
VENTILATING FANS
-
_3
X
$10
=
7 D
20
AIR HANDLER (DOES NOT include ducting)
= OR < 10,000CFM
41/4.
X
$12
=
21
AIR HANDLER (DOES NOT include ducting)
> 10,000 CFM
X
$19
=
22
EVAPORATIVE COOLERS
-
X
$10
-
23
TYPE I HOOD
-
X
$50
24
TYPE II HOOD
-
i
X
$10
; P
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
+50 TON
X
$60
=
30
LPG STORAGE TANK
-
X
$10
=
31
WOOD OR PELLET STOVE/INSERT
-
X
$10
=
32
WOOD STOVE - FREE STANDING
-
X
$25
=
--7aC
4IENT
1 — i
SUBTOTAL:
PLUS PROCESSING FEE:
$35.
TOTAL PERMIT FEE DUE: 7, Ot
DATE: EXPIRES:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
U,IgJOD 'S --fr I
City of
SPOKANE VALLEY
Fox
PERMIT # 13D D3 - (o2)14
BUILDING PERMIT APPLICATION
6 b'S o ° -V
Box 1 OWNER 1 Der-) JOB LOCATION s.
OWNER'S ADDRESS 32.4 sCIT\Q-ceh,c.csPHONE 3�-7-5 34iy
DESCRIBE JOB
'�LeS ck
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
PARTNERSHIP CORP.
BOX 2 CONTRACTOR'S NAME +-\ni Jew s PHONE S2-7-'53q 4
CONTRACTOR'S ADDRESS S- Ails
CITY r2r �� S
CONTRACTOR'S REG.# EXPIRATION DATE
(CARD MUST BE PRESENTED AND COPIED OR VERIFIED)
BOX 3 CONTACT PERSON OF PROJECT
r'rc.v
rk i s PHONE 3-70 c S 2-
ADDRESS ;:2y S CITY Grccv«c��s
ZIP `,��t�
BOX 4 SEWER AVAILABILITY WATER AVAILABILITY
BOX 5 ESTIMATED PROJECT COST $ EXISTING BLDG. VALUATION $
BOX 6 PROPERTY TAX ACCOUNT NUMBER I U
LEGAL DESCRIPTION
B
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION)
CENSUS NUMBER LOT NUMBER
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed) 1ST FLOOR (14 S /
2ND FLOOR /
3RD FLOOR / OTHER / BASEMENT FINISHED /
BASEMENT UNFINISHED 11 b / DECK -7.2 / GARAGE1).° /
CARPORT / TOTAL /
HEIGHT TO PEAK OF BUILDING
06, FT.
BOX 8 (✓-SINGLE FAMILY
( ) MULTIFAMILY (NO. OF UNITS
( ) COMMERCIAL / INDUSTRIAL
( ) TENANT IMPROVEMENT
( ) NEW CONSTRUCTION
( ) EXISTING STRUCTURE
TOTAL AREA OF PROPERTY 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 generally allowed in the City 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 OF MY KNOWLEDGE AND FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE
ABOVE PREMISES TO P F-E WORK FOR WHICH THE APPLICATION IS MADE.
OWNER / AGENT DATE 43/i / a 3 (OVER)
This document originally contained
I hereby authorize the City of Spokane Valleg
Visa Mastercard
to°ra cted pflAurr card�OrC`,IU ,I9Z55 which0 was re de pursuant o
and the original document destroyed
pursuant to SOS DAN G52014031 xP1rati0n
credit card:
Print the name of the Holder Lives -- .51.E , o N \.o,.zri" Signature
DO NOT PLACE ANY BUILDING UNDER POWER LINES OR OVER INCOMING GAS LINES.
vvNG1"
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
ASSIGNED ADDRESS
Received
DATE