2006, 10-19 Permit App 06004207 Residence, ExpiredProject Number: 06004207 Inv: 1
- Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/19/2006 Page 1 of 2
Project Information:
Permit Use: SFR, GAS HEAT, ON SEPTIC Contact: FIELDS, LOUIS & JOYCE
Address: 6024 E 11
C - S - Z: SPOKANE VALLEY, WA 99212
Setbacks: Front Left: Right: Rear: Phone: (509) 443-3704
Group Name:
Site Information:
Project Name:
Plat Key: 000188 Name: BETTMAN'S ADD District: E
Parcel Number: 35243.1037 Block:
SiteAddress: 1413 S FANCHER RD
Location:: CSV
Zoning: AGSUB
Water District:
Lot:
Owner: Name: FIELDS, LOUIS & JOYCE
Address: 6024 E 11
SPOKANE VALLEY, WA 99212
Hold: ❑
Area: .00 Acres Width: 91 Depth: 200 Right Of Way (ft): 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Review
Flood Plain
Building Plan Review
Driveway/Approach
Potable Water Review
Released By:
Released By: 3 j IT/ f n G
Released By:
Released By:
Land use/Zoning/HE Conditions
Released By:
/vf/q/0to
Operator: AMB Printed By: AMB Print Date: 10/19/2006
Project Number: 06004207 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed %r commencing work without a permit
Landuse/Zoning/HE Conditions
eiRe
view
Date: 10/20/2006 Page 2 of 2
Released By:
Originally Released: 10/19/2006 By: MBASINGE
Released By:
Perm its:
Approach —
Contractor: OWNER Firm: OWNER
Phone: (000) 000-0000
Contractor: OWNER
Contractor: OWNER
Contractor: OWNER
Notes:
Building Permit -
Firm: OWNER
Phone: (000) 000-0000
Mechanical Permit
Firm: OWNER
Phone: (000) 000-0000
Plumbing Permit
Finn: OWNER
Phone: (000) 000-0000
BETTMANS ADDITION - LOTS 7 THROUGH 18 OF BLOCK 8; AND LOTS 9, 10, 15 AND 16
OF BLOCK 5 HAVE BEEN PULLED OUT OF THE FLOOD PLAIN. SEE PLAT FILE.
Payment Summary:
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: AMB Printed By: AMB Print Date: 10/20/2006
e II?o7 E S raga APe, Sui6e
7r�,j yam►, WA sane
�,��J (509)688..0036 FAX: (5093? 0 an
ore \ftwit, Pernik C-enter
Comity Dever , -sPokanevallevixa
Residential Construction
Permit Application
SITE ADDRESS
ASSESSORS PARCEL NO: 2542143 D 3 7
-PERMIT FEE:
[�)[I L�1
New Construction ❑ Accessory Bldg
EI Addition/Remodel ❑ Deck
[] Other:
'•/ 44114s Qca A(61 o
94.AfJ 12,.BrL'tQ t. j 5...en
Pi -( tlr*e !yt S Ave et-lv4o-44V,
LEGAL DESCRIPTION: ; Gp p r 0 fry
Building Owner:
Nance Lou N J"-yam F; e-Ick
Address: c 4,../ t / ! # 1,
City_ 5 potex.-xe State: 144
Ey' #99 z 17
Phone. 5.9_, c f 3- 37 G y Fax
10
Contact Person
Name: ,J ,h Gcl, i el ✓L e c
Phone: (755) 69n - 3 /
Describe the scope of work in detail:
i
Contractor: n liy
Name:
Address:
City.
State: zip:
Phone: Fax
Contracr Lic No: Exp Date:
City Business Lic. No:
Cost of Project $ 120/aDD
a w 1,u l>o -Pot , l E5 ; d &i(
� writ NIA if act applicable) *'�
ma fo
**** **,tea _ - -- llowing MUST comp%e.
HEIGHT TO PEAK: DIMENSIONS: , # OF STORIES: �, TOTAL. HABITABLE E SPACE: 19 X.l6�'
MAIN FLOOR TO SQ. Z"` FL R SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE
FTG: AREA: 0
p /A 773 er-
FINISHED BASEMENT� GARAGE�FI, O DECK/PA��O_$C�. FTG: SLOPES ON , r�
SQ. FTG: ( / ( `f NV
# OF BEDROOMS: CONSTRUCTION TYPE HEAT SOURCE a_5 SEWER OR SEPTIC?
The Permkee verifies, acknowledges and agrees by their signature that I) If this penrmri is for construction of or on a dwelling. the
dwelrmg isAvill 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 owneror has permission to represent the property owner in this transaction. 4) All construction is to be done
in full comprence with the City of Spokane Valley Development Code. Referenced codes are available for review at the City of
Spokane Valley Penvit Center. 5) Tlis (Sty of Spokane Valley Permit is not a permit or approval for any violation of federal, state or
local laws, codes or ordinances. 6) Plans or additional hlfulnwtun+ may be required to be sulmmrlted, and subsequently approved before
this appicalion can be processed.
Signature L� -G%J--'
Method ofPayette*
❑ Cash
Bankcard #:
Authorized :
REVISED easrlooa
❑ cued(
Date /I) / / C)
❑ Mastercard �iISA
Expires: MN#:
(509X88-0036 FAX: (509Xi88-OOj7 �" Ole I '�; r
RECMWE,
Mechanical Permit Application ❑ Comme R
SITE ADDRESS: / `i 1 3 Fa tel.S cJt e(, .7 fJr9f/
i[ � GC�1
Community DevelDevelopmentt9iz/2 /
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
www.snokanevallev.org
Building Owner
Name:
J /
i U IA5 qG J C' elk f t /!ie S
Phone: 4, 1% 3- 37 0 9
Fax:Zip:
Address:
(, o ...2, If L--y 1 / -f--G,
City: Ste=//6a v e
State:
Lc .l AJ
Q
9 2
2_
Contractor
Name:
(2(2) e 1-A-2 C
Phone:
Fax:
Address:
City.
State:
Zip:
License No:
City Business Lic:
Contact
Name:
J // 44 ca (� C�1 � t, lr
Phone: (7 8 5) 6 vU
3 / t�
£
5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
DESCRIPTION OF WORK
FUEL BURNING APPLIANCE
FUEL BURNING APPLIANCE
UNLISTED APPLIANCE (Additional Fee)
UNLISTED APPLIANCE (Additional Fee)
USED APPLIANCE (WSEC min. AFUE rating)
USED APPLIANCE (WSEC min. AFUE rating)
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOILER/RE F RI GERATION
GAS LOG, GAS INSERT, GAS FIREPLACE
RANGE
DRYER
FUEL BURNING WATER HEATER
MISC. FUEL BURNING APPLIANCE
GAS PIPING (each outlet)
DUCT SYSTEMS
VENTILATING FANS
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include ducting)
EVAPORATIVE COOLERS
TYPE I HOOD
TYPE II HOOD
HEAT PUMP/AIR CONDITIONER
AIR CONDITIONER
AIR CONDmONER
AIR CONDITIONER
AIR CONDITIONER
LPG STORAGE TANK
WOOD OR PELLET STOVEIINSERT
WOOD STOVE - FREE STANDING
REPAIR & ADDITIONS
VENTILATION SYSTEMS
VENTILATION MECHANICAL EXHAUST
INCINERATOR - RESIDENCE
INCINERATOR - COMMERCIAL
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
CARD #:
AUTHORJZED SIGNATURE:
REVISED t/26r05
Equal to or less than 100,000
More than 100,000
Equal to or less than 400,000
More than 400,000
Equal to or less than 400,000
More than 400,000
1 - 100M BTU
101 - 500M BTU
501 - 1,000M BTU
1,001-1.750M BTU
More than 1,750M BTU
Equal to or less than 10,000 CFM
Greater than 10,000 CFM
0-3 TON
3-15 TON
15.30 TON
30-50 TON
More than 50 TON
EXPIRES:
# OF UNITS
0
0
(7
0
l
0
Q
0
0
(?
COST
$12.00
$15.00
$50.00
$100.00
S50.00
$100.00
$12.00
$20.00
$25.00
$35.00
$60.00
$10.00
$10.00
$10.00
$10.00
$10.00
$1.00
$10.00
$10.00
$12.00
$15.00
$10.00
$50.00
$10.00
$12.00
$20.00
$25.00
$35.00
$60.00
$10.00
$10 00
$25.00
$15.00
X $12.00
X 519.00
X $22.00
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
= TOTAL. AMOUNT
/Z
c2
J
0
(7
0
30
$35.00
Sliol(ane.s°\''
Community Development
D
Permit Center
11707E Sprague Ave, Suite 106
Spokane Valley, WA 99206 �_.
(509)688-0036 FAX: (509)688-0O 7
ww w.spokanevallev.orn
Plumbing Permit Application
SITE ADDRESS: / i/ / 3
OCT 2 (1
rimer cial �I�C�It1Rl
5 -1 e,JA
2
PERMIT NUMBER:
PERMIT FEE:
Building Owner
Name:
Lot/ / `5 # J vi re
is,&/G(S
Phone: 9 ...., 3) (' q
Fax:
Address:
6eU 5',/
C City p,-),,e_ki,,,e_
State:
L 6,,, -t
Zip:
.9...2 /
1
Contractor
Name:
C.,2Wr'L&S--
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
-�^ j
J `e=1 6: i CC/ 4e2 it
Phone: ( s. j) 6 `/,'
V C 5
.---
DESCRIPTION OF WORK
2
TOILETS
URINALS
WATER CLOSET, BIDETS
1i OF UNITS X
COST
TOTAL AMOUNT
z
$6.00
$6.00
3
4
5
6
TUBS
SHOWERS ER TRAP
SINKS
DISHWASHER
BATH, STALL, ON -SITE BUILT
LAVS/BAStNS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
7
CLOTHES WASHER
/
0
X
$6.00
$6.00
$6.00
$6.00
0
/Z
6
6
X
$6.00
6
8
GARBAGE DISPOSAL
$6.00
9
WATER SOFTENER
/
X
$6.00
6
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
$6.00
11
FLOOR DRAINS
12
ROOF DRAINS/OVERFLOW DRAINS
13
FOUNTAINS, DRINKING
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
AREA, CASE, COIL, TRENCH,
CONDENSATE
NSTALLATION, ALTERATION. REPAIR,
REVERSALS
$6.00
$6.00
6'
X
$6.00
$6.00
15
16
17
18
19
20
21
22
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
INTERCEPTORS
MEDICAL GAS (per outlet)
MISCELLANEOUS PLUMBING FIXTURE
PRIVATE SEWAGE DISPOSAL/SYS
INDUSTRIAL WASTE INTERCEPTOR
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 826I05
GRINDER, SUMP PUMP
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
NITROUS, OXYGEN
EXPIRES:
VIN:
C
0
0
o
X
$6.00
$6.00
$20.00
$15.00
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
0
L
r9
0
0
$35.00
Community Development
Approach Permit Application
Permit Center I n f 04F C E 1J E
11707 E Sprague Ave, Sltptc
Spokane Valley, WA 99/06
(509)688-0036 FAX: (509)688-04P. T
www.spokanevallev.org D)
IHL
NUMBER:
P tMIT FEE:
PROJECT ADDRESS % 2// 3 5 „Ivor , ,S0,01 edQ- %9,z /2-
START DATE ANTICIPATED COMPLETION DATE
Building Owner.
Contractor.
Name: toy aS $ JL c4 P, e1ds
Address: 6 2.Z 41 l/ f A
City: S p O k a ',Le_ State: UM Zip .-2/.Z
Phone: tiq' _ 3 7 Q if Fax:
Name: («71ti
Address:
Contact Person
Name: M Carcip-te_or-
Phone: %s, £7) C a 3 ` 6/
PROJECT DESCRIPTION (Provide site sketch)
Residential Driveway
Existing Curb & Gutter
Culvert Installation
Other Conditions
City:
State: Zip:
Phone: Fax:
Contractor Lic No: Exp Date:
City Business Lic. No:
Commercial/Industrial Driveway
Rural Road Section
Sidewalk Repair/Construction
Bond/Insurance certification must be on file with the city.
DISCLAIMER
The pennittee verifies, acknowledges and agrees by their signatures 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before this
application can be processed.
Signature '(,j'� Date
Method ofPayment
❑ Cash 0 Check D Mastercard 0 VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 3/9/06
a61b\s
ad � "C KR_
io Cu;arc `- k in ii rler
r�*dDa� �6kc1