2004, 05-10 Permit App BLD-04-04309 Residence, GarageSpokane
.00,Valley
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: 2325 S DUSK LN
SPOKANE VALLEY WA 99037
Description: NEW RESIDENCE W/ATTACHED GARAGE - NATURAL GAS
Subdivision:
Owner:
Applicant:
Address:
Contractor:
Address:
SHCHERBINA, PAUL & NATALYA
SHCHERBINA, PAUL & NATALYA
17731 E WELLESLEY AVE
SPOKANE VALLEY, WA 99216
Lot: Blk:
Application #: BLD-04-04309
Applied: 05/10/2004
Issued:
Expires: 11 /06/2004
Parcel No: Zoning:
Phone: (509) 869-2166
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
OCCUPANCY GROUP
CONSTRUCTION TYPE
STRUCTURES ON PROPERTY
CURRENT PROPERTY SIZE
SERVED BY SEPTIC SYSTEM
WELLS LOCATED ON PROPERTY
TOILETS
TUBS
SHOWERS (PER TRAP)
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
FUEL BURNING WATER HEATER
GAS PIPING (ea. OUTLET)
VENTILATING FANS
TYPE II HOOD
sfr
180622
28
68' 10" X 43' 4"
1
2
45
21
20
50
r-3
5-n
1
18209 SQ FT
no
no
2
1
2
5
1
1
1
1
2
1
1
1
1
3
3
1
Fees:
PLAN CHECK FEE
FUEL BURNING WATER HEATER
GAS PIPING
VENTILATING FANS
BASIC PERMIT FEE
WSBCC SURCHARGE
TOILETS
TUBS
SHOWERS
SINKS
DISHWASHER
CLOTHES WASHER
GARBAGE DISPOSAL
FLOOR DRAINS
WATER USING DEVICE
FUEL BURNING APPL <= 100,000
GAS LOG, INSERT, FIREPLACE
DRYER
Total Calculated:
Deposits/Receipts:
578.94
10.00
3.00
30.00
1,447.35
4.50
12.00
6.00
12.00
30.00
6.00
6.00
6.00
6.00
12.00
15.00
10.00
10.00
2,204.79
0.00
Total Due: 2,204.79
CITY SPOKANE VA
APPROVEDOF FOR SUBMf19LLEY
D FOR COD,E COMPLIANCE
SPOICAV�, BUILDING DIVISION
Initials / Date
Building
Planning /.mt
Public Works_ tc d At
THIS IS NOT A RECEIPT
Spo'lane
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: 5 J. i us& bhhe. pc kcui-�.f
1
Assessor's Tax Parcel Number(s): J 27 /% l
Legal Description: I%-tF, vL v11 L cX 1
PERMIT DESCRIPTION:
Building Permit
❑ Relocation
❑ Change in Use ❑ (Grading
?Qf-os7 thz),
❑ Manufactured Home
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: 1i w \ tV,-,3 r, (,, � -1,a�.iinc _ Ill Applicant:
Phone: Nei- it G, n Fax: N/A Phone:
Address: \-1"13i vn.(Q,(\.0,;(et.1 AVe-in«C) Address:
,(:).r1e VGA " (9i2.1 ( 0
City State Zip Code City
0
Fax:
irfr
Contractor:
Phone: 'r;ef•,y:Fax:
Address: s.+9)
CityState Zip Code
WA State Contractor License #:
Architect:
Phone:
State Zip Code
Address:
Fax:
City
Contact:
State Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK: ,�C X �'
DIMENSIONS:( 1 yy
tf OF STORIES:
MAIN FLOOR TO SQ. FTC: o,�r
2ND FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG: r c
FINISHED BASEMENT SQ. FTG:
GARAGE SQ. FTG: r �O
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP: 9,
CONSTRUCTION TYPE:(I fq(<-
HEAT SOURCE: /- s
# OF BEDROOMS: z
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: A+
30% SLOPES ON PROPERTY:
SEWER R ON -SITE SEPTIC
L
MANUFACTURED HOME
Width: Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler:
Tent:
Valuation:
# of Heads: Fire Alarm: Paint Booth:
Fireworks Display: Blasting: Date/Time:
Above/Underground Storage Tank Size:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
BOLTING
Firm Name:
Inspector(s):
❑ CONCRETE
❑ REINFORCEMENT
Phone:
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 deveeopment rights granted by any issued permit inure to the property owner.
VcruLL=-
Print Name (7 L L (7"(. l ,r /i'-✓ram C' Signature = C� `
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA ❑ Other
Bankcard #: Expires: VIN#:
Authorized Signature:
S`iolane
4, 0%lley
Project Address: 2
Owner: '?kt
Mailing Address: t [7 S 1 r
Contractor:
Mailing Address:
r.\i1�--'i�Il�(fei
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
t • ls,_r1 >; (El— Permit Use:
Phone (Daytime Contact):
State
Phone #:
License #:
City
Ci
y
State
DESCRIPTION OF WORK
# OF
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
UNITS
2-
X
$6.00
=
2
URINALS
- '
X
$6.00
3
TUBS
I
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
Z
X
$6.00
=
5
SINKS
LAVS/BASINS, 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
1
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
-s"—
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:
-
X
$6.00
=
VATS, TANKS, BOILERS
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:
SUBTOTAL
0 CASH 0 CHECK
PROCESSING FEE
835.00
0 VISA 0 MASTERCARD
DATE: EXPIRES:
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
Zip Code
Zip Code
AUTHORIZED SIGNATURE:
S fielane
Valley
Project Address. 1__s`
Owner: -1-cal MAtz* ,,ii1/4SVic Viecb1'r�e>r
Mailing Address -t21-1
Contractor:
Mailing Address:
License #: Phone#:
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
\fJA. Permit Use:
Phone (Daytime Contact): Eo !' Gi (Ai-,
I City / State Zip Code
t r
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
lei> /y
X
$15.00
=
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)
More than 400,000
-
X
$100.00
=
5
USED APPLIANCE (WSEC min, AFUE
rating)
Equal to or less than 400,000
,
X
$50.00
6
USED APPLIANCE (WSEC min. AFUE
More than 400,000
•-
X
$100.00
=
rating)
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$15.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$28.00
=
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
v
X
$95.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
9
r
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
$12.00
=
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
's'
X
$19.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I 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
'--`
X
$25.00
WOOD STOVE - FREE STANDING
METHOD OF PAYMENT:
0 CASH ElCHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
5
s‘A L mAE R�
ADDRESS
ZONE
ROAD WIDTH 30
FRONT -'
COMMENTS
REVIEWED BY
3ITE PLAN
FCry]
LINKING _
This site plan is bei
otlifining a build' g
...sensation o the
h ;s, dimensi
have been i
bodies of w
Signed:
Date:
' CA 111- 5/
g submitted for the purpose of
ermit and is a true and correct
proposal. All known property
nes, structures and easements
so indicated are wetlands,
opts or other critical areas.
-1'z-�o�