2004, 07-02 Permit App BLD-04-07008 Remodel GarageBUILDING 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:
f-2 0 I5 it% /_,- r- , c-
Assessor's Tax Parcel Number(s): v
Legal Description:
:. pp l' I , •sy4,4/f1/ 4/ (41-c
PERMIT DESCRIPTION: QH. vccrr, J
Building Permit ❑ Change in Use ❑ Grading ❑ Manufactured Home
❑ Relocation ❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
❑ Owner: R,b, r' D. 1..1Q Pi-,r,r-IA ❑ Applicant:
Phone: Cj - c l S 3 Fax: Phone: Fax:
Address: 7 61 R E . s iv, V ., AUK Address:
COY State Zip Code City State Zip Code
❑ Contractor:
❑ Architect:
Phone: Fax: Phone: Fax:
Address:
Address:
City State Zip Code City
State Zip Code
WA State Contractor License #: Contact:
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
2"8) FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENT SQ. FTG:
GARAGE SQ: FTG:
DECKICOV. PATIO SQ. FTG: ,
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
HEAT SOURCE:
# OF BEDROOMS:
TOTAL HABITABLE. SPACE:
IMPERVIOUS SURFACE AREA:
COST OF PROJECT: i //
() 00 0-
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM? ;',_3:• ,
MANUFACTURED HOME
Width:
Length: Year: Pit Set:
Manufacturer:
RELOCATION
Previous Address:
Proposed Use:
FIRE SAFETY
Fire Sprinkler: # of Heads: Fire Alarm:
Tent:
Valuation: Above/Underground Storage Tank Size:
Paint Booth:
Fireworks Display: Blasting: Date/Time:
WASHINGTON STATE NON-RESIDENTIAL ENERGY CODE
Plans Examiner:
Address:
Phone:
Fax:
City State
Inspector: Phone: Fax:
Address:
Zip
City
State
Zip
SPECIAL INSPECTIONS
D BOLTING ❑ CONCRETE
Firm Name:
❑ 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 Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA E Other
Bankcard #: Expires: VIN#:
Authorized Signature:
Si�'
lley
Project Address: , ?C / S /14/ F r r c-I
Owner: �� o �� �� _�_ L) • LA) e jf1 f o o i--i'in
Mailing Address:
Contractor:
c, A-U
Mailing Address:
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
Permit Use:
Phone (Daytime Contact):
License #:
City
KxIlc/
State
Phone #:
Zip Code
City
State
DESCRIPTION OF WORK
# OF
UNITS
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
LAVS/BASINS, BAR, FLOOR,
KfTCHEN, 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
t
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:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
Zip Code
AUTHORIZED SIGNATURE:
•
3 ZF.eww {C ORA 44(..m73)TO I
.TVAH 1,41-t2 WAAlts')31P.4`•490t1 rAtk ::1141.11'3ww_
1 T '21:. ti i•J,.54-; i )ArA31AM(I
FOUNDATION PLAN
i,
PLEASE COMPLETE THE FOLLOWING INFORMATIOk AND ADD ON THE
DRAWING BELOW
BUILDING DIMENSIONS:
32 x 3
GARAGE DOOR OPENINGAND HEADERSIZE • 7 x iG
INDICATE THE LOCATION AND SIZE OF ALL WINDOWS AND DOORS ON
THE PLAN
2
.?
sL9
Ridge Line
Head e_r
_Cq) aXio
IC c
.. Width
Dsor
0 0 r
36"
1 if
7
•
3
Tease note that while every effort is made to assure the accuracy of the information contained In this brochure it is not warranted for accuracy.
Phis document is not intended to address all aspects or regulatory requirements for a project and should serve as a starting point for your investiga-
.ion. For detailed information on a particular project. permit, or code requirement refer directly to applicable file and/or code/regulatory documents or
:ontact the appropriate division or staff,
<.
�:,- _ '2UM A.J9 : BHT