2004, 06-11 Permit App BLD-04-04580 Residence, Garage*Wane
..• "`Milley
11707 E. Sprague Ave., Suite 106
Spokane Valley, WA 99206
THIS IS NOT A PERMIT
Penalties will be assessed for
commencing work without a permit
NEW SINGLE FAMILY RESIDENTIAL
Job Address: 2315 S DUSK LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
SICHKAR, VASILIY
SICHKAR, VASILIY
1522 W SHANNON AVE
SPOKANE, WA 99205
Application #:
Applied:
Issued:
Expires:
BLD-04-04580
06/11/2004
12/08/2004
Lot: Blk: Parcel No: 4I5_�L5) I O Zoning:
�L I* I r�
Phone: (509) 326-7253
Phone:
Lic No:
General Information:
TYPE OF RESIDENTIAL PERMIT
VALUATION
BUILDING HEIGHT TO PEAK
DIMENSIONS
# OF STORIES
# OF BEDROOMS
FRONT SETBACK
REAR SETBACK
LEFT SETBACK
RIGHT SETBACK
FLANKING SETBACK
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOI LETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
sfr
236076
28
92X60
2
5
20+
32
15
21
15
r-3
5-n
1
20480
no
no
6
1
2
10
1
1
2
1
1
1
2
5
1
Fees:
PLAN CHECK FEE
BASIC PERMIT FEE
WSBCC SURCHARGE
TOI LETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
DRYER
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
Total Calculated:
Deposits/Receipts:
Total Due:
704.38
1,760.95
4.50
36.00
6.00
12.00
60.00
6.00
6.00
12.00
15.00
10.00
10.00
2.00
50.00
2,694.83
0.00
2,694.83
CITY OF SPOKANE VALLEY
APPROVED FOR SUBMITTAL_ EWED FOR CODE COMPLIANCE
initials / Date SP'NE VALLEY UIL DIDIVISION
Building
Planning (�(�
Pubic
THIS IS NOT A RECEIPT
BUILDING PERMIT APPLICATION WORKSHEET
City of Spokane Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
REQUIRED SITE INFORMATION
Street Address: I C 7ia Du Clt "-
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
+� Building Permit Change in Use
Relocation
Tenant Improvement
fI
Grading
Fire Safety
Manufactured Home
Other
OWNER/APPLICANT INFORMATION
i
Owner: tiffV c;7CHA1
Phone: 326 /2 5 La> Fax:
Address: in/ i5 22 S'HANND /tvc
v'Pok NE V✓I{ (VI 2CS-
Applicant: 0wh
Phone:
Address:
Fax:
City Stae.S`7 Zi Code City State Zip Code
Contractor: OW t� e. L Architect:
Phone: Fax: Phone: Fax:
Address: Address:
City
State Zip Code
WA State Contractor License #:
City
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: 2 8 °
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG: 7 ? y)
2"" FLOOR SQ. FTG: rri
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
Go J
GARAGE SQ. FTG:
,II10
DECK/COV. PATIO SQ. FTG:
10
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
Do-, Clint $ . At16 f1 e-2
HEAT SOURCE:
G A ,5,'
# OF BEDROOMS:
TOTAL HABITAB E SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT:
30% SLOPES ON PROPERTY:
i L -�
SEWER OR ON -SITE SEPTIC
SYSTEM? Lt.6 Q
MANUFACTURED HOME
Width:
Manufacturer:
Length: Year: Pit Set:
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:
Address:
Phone:
Fax:
City
Inspector: Phone:
Address:
State
Fax:
Zip
City
State
Zip
SPECIAL INSPECTIONS
BOLTING
Firm Name:
CONCRETE
REINFORCEMENT
Phone:
Inspector(s):
Fax:
WELDING
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 inure to the
property owner..
Print Name VA-5 t(`f ('�'(iuA-a_ Signature et.g1 5CJ]'v7-6-"d
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check
Bankcard #:
Authorized Signature:
❑ Mastercard
n VISA
❑ Other
Expires: VIN#:
Spokane
Valley
MECHANICAL PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: Permit Use:
Owner:
Mailing Address:
Contractor:
Mailing Address:
Phone (Daytime Contact):
City
License #: Phone #:
State
Zip Code
D
DESCRIPTION OF WORK
""a
# OF
UNITS
X
COST
=
State
TOTAL
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$15.00
AMOUNT
2
FUEL BURNING APPLIANCE
More than 100,000
X
$19.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
$50.00
=
4
UNLISTED APPLIANCE (Additional Fee)
USED
More than 400,000
X
$100.00
=
5
APPLIANCE (WSEC min. AFUE
rating)
USED
Equal to or less than 400,000
X
$50.00
=
=
6
APPLIANCE(WSEC min. AFUE
rating)
More than 400,000
X
$100.00
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$26.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$39.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$57.00
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$95.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
X
$10.00
14
DRYER
X
$10.00.
15
FUEL BURNING WATER HEATER
X
$10.00
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
X
$1.00
_
18
DUCT SYSTEMS
X
$10.00
=
19
VENTILATING FANS
X
$10.00
=
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$1200
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
$19.00
22
EVAPORATIVE COOLERS
X
$10.00
23
TYPE HOOD
X
$50.00
=
24
TYPE II HOOD
X
$10.00
=
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
$12.00
=
26
AIR CONDITIONER
3-15 TON
X
$20.00
=
27
AIR CONDITIONER
15-30 TON
X_
$25.00
28
AIR CONDITIONER
30-50 TON
X
$35.00
=
29
AIR CONDITIONER
More than 50 TON
X
$60.00
=
30
LPG STORAGE TANK
X
$10.00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
=
=
32
WOOD STOVE - FREE STANDING
X
METHOD OF PAYMENT:
0 CASH ElCHECK 0 VISA 0 MC
CARD#:
DATE:
SUBTOTAL
$25.00
=
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
Zip Code
AUTHORIZED SIGNATURE:
So kane
Valley
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: Permit Use:
Owner:
Phone (Daytime Contact):
Mailing Address:
State Zip Code
City
Contractor: License #: Phone #:
Mailing Address:
City State Zip Code
DESCRIPTION OF WORK
# OF
UNtTS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
$6.00
=
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
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P,D. FOR:
VATS, TANKS, BOILERS
X
$6.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
ADDRESS
ZONE
ROAD WIDTH bL,
FRONT �..—,FUNKiNG
COMMENTS
REVIEWED BY
SITE PLAN
SCALE: l "=30'
This site plan is obtainbeing submitted for the purpose of
g building permit and Is a true and correct
representation of the proposal. AN known party
lines/dimensions. curb lines, structures and easements
have been identified. Also indicated are wetlands,
bodies of walerteep or critical areas.
Signed: / ./1 > aNn
Date:�',��