2005, 06-14 Permit App 05002028 2 Story Addition, GarageProject Number: 05002028 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: TWO STORY ADDITION W/GARAGE TO
RESIDENCE
Setbacks: Front 64+ Left: EX Right: 50+ Rear: 50+
Site Information:
Date: 06/14/2005 Page 1 of 3
Contact: KILGORE, DWANE
Address: 1714 N FLORA RD
C - S - Z: SPOKANE VALLEY, WA 99016
Phone: (509) 928-7044
Group Name:
Project Name:
Plat Key: 001869 Name: ORCHARD AVE ADD REPLAT B 151,152, (FEES)
immarmarAgromommmeampommastata
District: Nort
Parcel Number: 55073.1439 Block:
SiteAddress: 1714 N FLORA RD
Location:: CSV
Zoning: UR-3.5
Water District:
Urban Residential 3.5
Area: .00 Acres
Lot:
Owner: Name: KILGORE, DWANE
Address: 1714 N FLORA RD
SPOKANE VALLEY, WA 99016
Hold: 0
Width: 138 Depth: 300 Right Of Way (ft): 60
Nbr of Bldgs: 4 Nbr of Dwellings: 1
Review Information:
Review
Site Plan Review
Plan Review
Released By:
ki\kilib.Thpuk_)
Septic System Review
Permits:
Released By:
Operator: K_C Printed By: K_C Print Date: 06/14/2005
06/20/2005 15:33 5093241557
JUN 14 2005 16:13 FR .' 7`i
SKHU t1-15
TO 3241567 P.0;/03
Project Number. 05002028 Inv: 1 App1ii ation
THIS IS NOT A PE IT
Penalties will be assessed for commencing work without a permit
...;Z:0 "�tt'd;;:,;S1d1Ft^+3ir'L'hiJ.xr`+xe.,X1�,s,«:. 5!.1....r........:., 4 ��„
Permit Use: TWO STORY ADDITION W/GARAGE TO Coc-iIact: KILGORE, DWANE
RESIDENCE Address: 1714 N FLORA :RD
C - Si - Z: SPOKANE VALLEY, WA 9! 10l 6
Setbacks: Front 64+ Left: EX Right: 50+ Rear: 50+ P One: (509) 928-7044
Group N e:
Site Info Project_ ,,... y_.,. ..
Information: ,,,..., a xn
:u.r•:��..,:xat:srax3�rs:.r+:�a•���r.5;�a�;�,a�.,3;..M,..JrK9!�:��;r� . � District: Nor
rR..tox. fir.,�.�,.,,.,;.,�...�..,_a.,.,....,:-.:.,.:} ..,, .:
Plat Key: 001869 Name: ORCHARD AVE ADD REPEAT B 151,1jS2, (FEES)
Parcel Number: 55073.1439 Block: Lot:
Owner:SiteAddress; 1714 N FLORA RD
Name: KILGORE, DWANE
Address: 1714 N FLORA RD
SPOKANE VALLEY, WA 99016
Location:: CSV
Zoning: UR-3.5
Water District:
Urban Residential 3.5
Hold: ❑
Area: .00 Acres Width: 138 Depth: 300 I Might Of Way (ft): 60
Nbr ofBldgs: 4 Nbr ofDwellinga: 1
Review Information: -. - .-..�. „a -.r . _ , a.. _.> �., _. _...., .......r . �:�:.:•
....
Date: 06/14/2005 Page 1 or3
Revie W
Site Plan Review
Released By:
Plan Review
Septic System Review
Released
1,11 )41,44.A‘41.2
Permits: •
i:Arty, :a�crzur�47,rez 1::: �..��:z:r:..1.-:fr igs.,Sxuwlr rs ridgME ONErxtx1:sg212212 7:u ,w::.::: :..-.Y. �-:V7:..-;: ..., : , .
Operator: K C
Printed By: K_C Print Date:
06/14/2005
s;.....;. r n
JUN 20 2005 16:43
5093241567 PAGE.02
Project Number: 05002028 Inv: 1
Application
Date: 06/14/2005 Page 2 of 3
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Group: R-3 Type: VB
Total Area 1087
Building Height 27.5
Stories 2
Dwelling Units 1
Building Permit
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
2ND FLOOR R-3 VB 456 $34,054.08 456 $34,054.08
GARAGE U-I VB 576 $10,944.00 576 $10,944.00
RES ADD R-3 VB 631 $47,123.08 631 $47,123.08
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Item Description
VENTILATING FANS
CLOTHES DRYER
HOOD -TYPE II
Contractor: OWNER
Totals: 1,663 $92,121.16 1,663 $92,121.16
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Fee Amount
$944.75
$4.50
$377.90
$1,327.15
Finn: OWNER
Phone: (000) 000-0000
Units Unit Desc
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Permit Total Fees:
Plumbing Permit
Fee Amount
$30.00
$10.00
$10.00
$50.00
Firm: OWNER
Phone: (000) 000-0000
Item Description Units Unit Desc Fee Amount
TOILETSBIDETS 3 NUMBER OF $18.00
SINKS 4 NUMBER OF $24.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
Permit Total Fees: $66.00
Operator: K_C Printed By: K_C Print Date: 06/14/2005
Project Number: 05002028
Inv: 1
Application
Date: 06/14/2005 Page 3 of 3
Notes:
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary: >;
Permit Type
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount
$1,327.15
$50.00
$66.00
Invoice Amount
$1,327.15
$50.00
$66.00
$1,443.15 $1,443.15
Amount Paid Amount Owing
$0.00 $1,327.15
$0.00 $50.00
$0.00 $66.00
$0.00 $1,443.15
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: KS Printed By: K_C
Print Date: 06/14/2005
Spo°`kane
jUalley
.B
EC Qtkotk
ING PERMIT APPLICATION WORKSHEET
Valley Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
one: (509) 688-0036; Fax: (509) 688-0037
I
REQUIRED SITE INFORMATION
Street Address:
Assessor's Tax Parcel Number(s):
Legal Description:
PERMIT DESCRIPTION:
Building Permit ❑Change in Use El Grading II) Manufactured Home
Relocation
❑ Tenant Improvement ❑ Fire Safety ❑ Other
OWNER/APPLICANT INFORMATION
Owner: / ,r vi
Phone:
Address: 4
C State
❑ Contractor.
Phone: z�D f ax:
Address: �
Zip Code
State Zip Code
❑ Applicant:
Phone:
Address:
Fax:
City State
❑ Architect:
Zip Code
Phone: Fax:
Address:
City
State Zip Code
WA State Contractor License #: Contact:
Spokane Valley Bus. Liscense #: Contact:
PERMIT/BUILDING INFORMATION
i
HEIGHT TO PEAK: ,, , .,
DIMENSIONS:
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
214° FLOOR SQ. FTG:
UNFIN BASEMENT SQ. FTG:
FINISHED BASEMENTS FTG:
GARAGE SQ. FTG:
5-76
DECK/COV. PATIO SQ. FTG:
t o
OCCUPANCY GROUP:
CONSTRUCTION TYPE:
H,SOURCE:
EAT
L r
# OF BEDROOMS: /
TOTAL HABITABLE SPACE:
IMPERVIOUS SURFACE AREA:
il
COST OF PROJECT:
30% SLOPES ON PROPERTY:
SEWER OR ON -SITE SEPTIC
SYSTEM? - , ; L-F : `�
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: Phone: Fax:
Address:
City State Zip
Inspector: Phone: Fax:
Address:
City
State Zip
SPECIAL INSPECTIONS
El 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 developme t rights granted by any issuedpermifinur to the property owner.
1
> 1� S ign atute----- �"
Print Name_
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
:71 Cash
-ikcard #:
❑ Check
❑ Mastercard ❑ VISA
Expires: VIN#:
n Other
rized Signature:
BP'e
Project Address:
Owner.
Mailing Address:
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
Phone (Daytime Contact):
Contractor. -�
Mailing Address:
City
License #:
State
Phone #:
Zip Code
Zip Code
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12.00
=
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15.00
=
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 Tess than 400.000
X
$50.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
$12.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20.00
=
9
BOILER/REFRIGERATION
501-1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
$60.00
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10.00
=
13
RANGE
X
$10.00
=
14
DRYER
)
1
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
3
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
X
$15.00
=
22
EVAPORATIVE COOLERS
X
$10.00
=
23
TYPE I HOOD
X
$50.00
=
24
TYPE II HOOD
1
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
$25.00
=
33
REPAIR & ADDITIONS
X
$15.00
=
34
VENTILATION SYSTEMS •
X
$12.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR - RESIDENCE
X
$19.00
=
37
INCINERATOR - COMMERCIAL
X
522.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MC
CARD #:
DATE:
SUBTOTAL
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
*me
4,ValleY
Project Address:
Owner.
PLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Mailing Address:
Contractor.
Permit Use:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone (Daytime Contact):
Mailing Address:
City
License #:
State Zip Code
Phone #:
City
State
Zip Code
D
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
2.
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
�—f
11
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
NSTALLATION, 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
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK
DATE
SUBTOTAL
0 VISA ❑ MASTERCARD
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
1
d
,-7[4_,L, / 7/9/4/
edge 04- -136,,cK`roh
This site plan is being submitted for the purpose of
obtaining a building permit and is a true and correct
representation of the proposal. All known property
lines/dimensions, curb lines, structures and easements
have been identified. Also indicated are wetlands,
bodies of water, steep slopes or other critical areas.
Signed -
Date'
ADDRESS: /1
ZONE:
ROAD WIDTH:
FRONT tLAN,KING;
COMMENTS: 1
REVIEWED
1.
3°
\✓
K to