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2006, 07-07 Permit App 06002525 Residence, HeatProject Number: 06002525 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SFR, GAS HEAT, ON SEPTIC Setbacks: Front Site Information: Plat Key: Left: Right: Rear: Name: Range Date: 7/7/2006 Page 1 of 3 Contact: MARKHAM HOMES, INC Address: PO BOX 610 C - S - Z: LIBERTY LAKE, WA 99019 Phone: (509) 927-1437 Group Name: Project Name: District: East Parcel Number: 55182.2744 Block: SiteAddress: 17303 E BROADWAY AVE Location:: CSV Zoning: UR-3.5 Water District: Urban Residential 3.5 Area: 18,123 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Lot: Owner: Name: MARKHAM HOMES, INC Address: PO BOX 610 LIBERTY LAKE, WA 99019 Hold: u Depth: 0 Right Of Way (ft): 0 Review Building Plan Review Released By: Driveway/Approach Originally Released: 6/29/2006 By: TMELBOU Released By: Originally Released: Septic Sys Review 7/7/2006 By: amblake Released By: see file Originally Released: 7/7/2006 By: a_blake Landuse/Zoning/HE Conditions Released By: Originally Released: 7/7/2006 By: Cdesimas Operator: AMB Printed By: AMB Print Date: 7/7/2006 Project Number: 06002525 Inv: 1 Permits: Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Contractor: MARKHAM HOMES INC Address: 2510 N. PINES, SUITE 203 SPOKANE, WA 99206 Item Description APPROACH-CONST IN ROW Contractor: MARKHAM HOMES INC Address: 2510 N. PINES, SUITE 203 SPOKANE, WA 99206 Description Grp Type 1&2 FAMILY R-3 VB 2ND FLOOR R-3 VB DECK OPEN R-3 VB GAR WOOD U-1 VB Item Description RESIDENTIAL PERMIT FEE WSBC SURCHARGE SF PLNS RVW < 7999 SQ FT Notes Approach Date: 7/7/2006 Page 2 of 3 Firm: MARKHAM HOMES INC Phone: (509) 927-1437 Units Unit Desc 1 NUMBER OF Permit Total Fees: Building Permit Fee Amount $50.00 $50.00 Firm: MARKHAM HOMES INC Phone: (509) 927-1437 This Application: Total Project: So Ft Valuation Sq Ft Valuation 979 $84,556.23 979 $84,556.23 1,062 $79,310.16 1,062 $79,310.16 100 $1,500.00 100 $1,500.00 476 $9,044.00 476 $9,044.00 Totals: 2,617 $174,410.39 2,617 $174,410.39 Units 1 1 1 Contractor: COMFORT CENTRAL HEATING Address: PO BOX 28924 SPOKANE WA 99228 Item Description DUCT SYSTEMS GAS WATER HEATER AIR CONDITIONER:4-15 TONS VENTILATING FANS HOOD - TYPE I CLOTHES DRYER RANGE Unit Desc SELECT SELECT SELECT Permit Total Fees: Mechanical Permit Units 1 1 1 4 1 1 1 Fee Amount $1,413.75 $4.50 $565.50 $1,983.75 Firm: COMFORT CENTRAL HEATING Phone: (509) 216-1223 Unit Desc NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF Permit Total Fees: Fee Amount $10.00 $10.00 $20.00 $40.00 $50.00 $10.00 $10.00 $150.00 Operator: AMB Printed By: AMB Print Date: 7/7/2006 Project Number: 06002525 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Plumbing Permit Date: 7/7/2006 Page 3 of 3 Contractor: C & K PLUMBING Firm: C & K PLUMBING Address: 5231 W NAVAJO Phone: (509) 489-3906 SPOKANE, WA 99208 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 3 NUMBER OF $18.00 SINKS 4 NUMBER OF $24.00 SHOWERS 3 NUMBER OF $18.00 TUBS 3 NUMBER OF $18.00 DISH WASHERS 1 NUMBER OF $6.00 GARBAGE DISPOSAL 1 NUMBER OF $6.00 CLOTHES WASHER 1 NUMBER OF $6.00 CROSS CONNECTION DEVICES 1 NUMBER OF $6.00 WATER PIPING - DWV 1 NUMBER OF $6.00 Permit Total Fees: $108.00 All driveway approaches to be constructed per Spokane County Standards as adopted by the City of Spokane Valley. Minimum of 7.5' from each property line, 5' from crosswalks or intersection curb and minimum of 15' of separation between any two approaches. Flat portion of a residential approach to be minimum of 16' wide, maximum of 30' wide and combined approach width not to exceed 50% of total frontage. SEPTIC SYSTEM DESIGNED FOR MAXIMUM 360 GALLONS PER DAY. Payment Summary: ;. Permit Type Approach Building Permit Mechanical Permit Plumbing Permit Fee Amount $50.00 $1,983.75 $150.00 $108.00 Invoice Amount $50.00 $1,983.75 $150.00 $108.00 Amount Paid Amount Owine $0.00 $50.00 $0.00 $1,983.75 $0.00 $150.00 $0.00 $108.00 $2,291.75 $2,291.75 $0.00 $2,291.75 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: 7/7/2006 07/07/2006 11:20 50r93r241567rc ac,-er SRHD EHS Fax TO 3241567 PAGE 01 P.01i06 ' BUILDING DIVISION 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 11707 E Sprague Ave Suite 106 ♦ Spokane Valley WA 99206 509.921.1000 • Fax: 509.688-0037 ♦ cityhall@spokanevalky.org To: Don Copley From: Anita I°ax: 50a1324.4507 Pages: 6 Including cover INhone: Date: 6/30/200B Re: 17303 E. Broadway CC: We just wanted you to know that a building permit will not be issued on this project until approval by the Spokane Regional Health District. This is your call. I you should have any questions, please don't hesitate to contact me at 868-0234. Thank you /mita Blake Permit Specialist JUL 07 2006 12:40 5093241567 PRGE.01 07/07/2006_11: 20 5093241567 SRHD EHS TO 3241567 Project Numb : 06002525 Inv: I Application Date: 06/28/2006 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit frineetitto station; Permit List S FR, GAS HEAT, ON SEPTIC PAGE 02 P.01/04 Page 1 of 2 Setbacks: Fr cart Left: Right: Rear: Site Inftarttuyion: Plat Kr y Name: Range PaeLunter: 51182.2744 Contact: MARKHAM HOMES, INC Address: PO BOX 610 C - S - Z: LIBERTY I Aim, WA 99019 Phone: (509) 921-1437 Group NaMe: Project Name: Block: :3i teAddress: 17305 E BROADWAY AVE Location:: CSV Zoning: UR4.5 Urban Residential 3.5 Water District Arca: 18,123 Sq Ft Width: 0 Nix of Bldgs: 0 Nbr of Dwellings: 0 Review Itsilrmation; Ehzt BM le ing Plan Review Driv :way/Approach Sept ic Sys Review &Unit so dust/Zoning/HE Conditions District: East Lot Owner: Narne: MARKHAM HOMES, INC Address: PO BOX 610 LIBERTY LAKE, WA 99019 Hold: Depth: 0 Right Of Way (ft): 0 th�it fOr a max et , 7113fAtt="'"'.. until swans lasminlion has SCIHD emonntaL ,crithiskittimai!}14004 '03 °fluor: AMB Printed By: AMB Print Date: 06/28/2006 JUL 072006 12:40 5093241567 PAGE.02 07/07/2006__11_20 5093241567 S 89453'18" SRHD EHS TO 3241567 102.97' u-1 PAGE 03 P.04/04 0014'56` E 17' PROPOSED BARN ' BACON'S ADDITION LOT 4 18,123 sq.ft. 17303 E. BROADWAY 42' N N d 0 0 z ASPEN 2-CAR 102.94' N 89'59 33" E LEGEND 0 10 20 - LOT BOUNDARY = 8' BORDER EASEMENT 10' UTILITY EASEMENT 40 60 SCALE IN FEET N asserninerasa P.0 BOX 610 LIBERTY LAKE, WA 99019 (509) 927-1437 ** TOTAL PRGE.04 w* JUL 07 2006 12:40 5093241567 PRGE.03 07/07/2006 11:20 __ 5093241567 �I � permit Center y nine 11707 E Sprague A "rj' t 7i j Spokane Valley, w. (509)686-0036 F CommunityDevelopment Resider dal Construction Permit Application SRHD EHS TO 3241567 EnivE v+� J GrR10 l 11 IsAavido ction o Accessory Bldg ❑ Addition/Remodel ❑ Deck ❑ Other: PAGE 04 P.02/04 SITE ADDF.FSS ASSESSOR 3 PARCEL NO: Name: _;,..04 n), Phone: 4/2 7 - iltg"g- 5187 " tCLEOALDEscur om L4 4 • „.j3 —OI - 04. Describe the scope of work in detail: Name: Mark. Clem govvi e5) I h C" it Address: 0. City: //x ,10 L.1,e 4 smoke Zip: diciO/cci Phone: q -f437 Fax: Lic No: Exp. Date: City Business Lic No: Cost of Project: $ lqq/ ciso *******et* k r***The 70 .2' MAIN FLOOR TO SQ. FIG: DECK/GOV. PATIO SQ. FTG: 30%, SLOPES ON /Gb -ca. FTC, . PROPERTY: HEA,T SOURCE; SEWER OR SEPTIC? trCeedi Qiir The pormitee . e rifles, acknowledges end agrees by their signature that 1) If this nand Is for construction of or on a dwelling. the dwelling le/will be served by potable water. 2) Ownership of this Clty of Spokane Valley Permit inure to the property owner. 3) The signatory is !hi: property owner or has permission to represent the property owner in this transaction. 4) All construction is to be done in till ampler c3 with the Ctty of Spokane Valley Development Coda. Referenced codes aro available for review at the City of Spokane Valle( F'ennit Center. 5) Thls City of Spokane Valley Permit is not a permit or approval for any violation of federal, state or local laws, oxtail or ordinances. 6) Plans or additional Information may be required to be submitted, and subsequently approved before 612.6/06 FINISHED BASEM NT SQ. FTG: tCV J1 OF BEDROOMS: R Stgneturessc_ following MUST be complete:(write NIA ifnot applicable)********************** DIMENSIONS: # OF STORIES: TOTAL HABITABLE SPACE: 44' k 36 ,.Z. 2-16-4- 2N0 FLOOR SQ. FTG: UNPIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE tZO o -'.t6-- AREA: 7� GARAGE lSQ. FTG: CONSTRUCTION TYPE: Date Method Pa)n7ent (Fared permit applications will onrybe accepted with mrrlorbankcard) ❑ 0 Codash hrD Check 0 Mastercard 0 VISA Expires: VIN#: Authortzsa 51t it ature: REwseoeoos 0 Other JUL 07 2006 12:41 5093241567 PRGE.04 07/07/2006 11:20 _ 5093241567 SRHD EHS TO 3241567 PAGE 05 P.03/04 P1D: 155132 2744 NYBhlrorne oa: [ J Stta qudraas IRO* inkr116100100 Buffer Resetb FVIndatiencup _ C QueAi�' Rditlkep E� ei etJrLTt. : 1,4l Raor$la i ACO Neighborhood Site Addraaa See Site Own Ownot Name ��gGYIISgRIi��l�r�l'gS�q��Kq!lBgilq���[� http:/r d orado/mox42/index.c9n?action=mox42_if_pxism&screenileight^531 &acreenWid... 06/28/2006 JUL 07 2006 12:41 5093241567 PRGE.05 Project Number: 06002525 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SFR, GAS HEAT, ON SEPTIC Setbacks: Front Site Information: Plat Key: Left: Right: Name: Range Rear: Date: 06/28/2006 Page 1 of 2 Contact: MARKHAM HOMES, INC Address: PO BOX 610 C - S - Z: LIBERTY LAKE, WA 99019 Phone: (509) 927-1437 Group Name: Project Name: District: East Parcel Number: 55182.2744 Block: SiteAddress: 17303 E BROADWAY AVE Location:: CSV Zoning: UR-3.5 Water District: Area: 18,123 Sq Ft Urban Residential 3.5 Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Lot: Owner: Name: MARKHAM HOMES, INC Address: PO BOX 610 LIBERTY LAKE, WA 99019 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Review Building Plan Review Released By: —TR. •G / 2- Driveway/Approach Released By: Septic Sys Review (a(af c•er- - %ri ick• Released By: Landuse/Zoning/HE Conditions Permits: Lh 4,d'1 �it e1� d Released Byt:er ri /'d4 �'l.a ✓tad 4 e7 „/ C' 711 4GlJ. ceeCer Operator: AMB Printed By: AMB Print Date: 06/28/2006 ��, Permit Center } i >rC Straka. e 11707E Sprague A jade E 0 V (Z '�alle Spokane Valley, WA 99206 CS 509 688-0036 FAX: 509 6 �T Community Development rw.spokanevalley,org.com�" J 2 0 Residential Construction Permit Application U env onction ❑ Addition/Remodel ❑ Other: ❑ Accessory Bldg ❑ Deck SITE ADDRESS•r cI W� ASSESSORS PARCEL NO: - 18z a' 4.°LEGAL DESCRIPTION: - r' �' s- D ( - CRIPTION. .�. D�(-• Building owner;; L ., ,.; Name: r--; q v, - ; o s 1 — Address: City:, Zip: Phone: — *: g Fax: onfiact erg Name: o n?, Phone: 42;2 - 14Z Describe the scope of work in detail: Contractor . r --- Name:.. I" f'r✓K �avir, I-oWi es 1 �1 C. Address: P o • �o x lO City: L- er -I-y L- h Zip: CJc 0 / Ci Phone: G% — (4,? 7" Fax: <5:72 - 2 /6 Lic No: Exp. Date: City Business Lic No: Cost of Project: $ q - **************The following MUST be complete: (write NIA if not applicable)********************** HEIGHT TO P. DIMENSIONS: # OF STORIES: TOTAL HABITABL PA( CE: MAIN FLOOR TO SQ. FTG' 79 2Nu FLOOR SQ. FTG: 2-(,-)._AREA: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE FINISHED B SEME _ SQ. FTG: GARAGE SQ. FTG: '/ , - So, FT C - DECK/COV. PATIO SQ. FTG: / 00 Sc.. f- 7 q . 30% SLOPES ON PROPERTY: # OF BEDROOMS: CONSTRUCTION TYPE: HEAT SOURCE: ��s 'cc A; ✓.-' SEWER OR SEPTIC? 4---Ti G 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. 6) Plans or additional information may be required to be submitted, and subsequently approved before phis-applieatio-can-be-process. Signature Date Method of Payment: (Faxed permit applications will only be accepted with major bankcard) ❑ Cash ❑ Check ❑ Mastercard ❑ VISA Bankcard #: Expires: VIN#: Authorized Signature: REVISED 8/25/2005 6/z 6 /o 6 ❑ Other Permit Center S�e 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (Valley (509)688-0036 FAX:(509)688-0037 www.sookanevallev.orti.com Community Development Residential Plan Submittal Minimums ❑ Completed Building, Plumbing & Mechanical application with: Accurate address, Parcel Number and/or Legal Description, description of work, owner and contractor information, signature, and date. ❑ Two sets of plans including Site Plan, elevations, floor plans, foundation plans With details, roof plan, framing plans & details. ❑ Show the height of any proposed buildings or accessory structures. ❑ Floor plan for each floor: Dimension to scale (minimum 1/8") and label each Room (including sq. footage of house and garage on plans) Show each level of existing house and square footage of any additions. ❑ All braced wall panel types: show locations and details of installation, including engineered design. ❑ Egress windows: Provide at least one window or exterior door approved for Emergency escape or rescue from a basement and in every room for sleeping. ❑ Smoke detector locations ❑ 22" X 30" attic access location ❑ 18" X 24" crawl space access: ❑ One -hour separation detail: between house and garage ❑ Floor framing details: Joist type, size, 'spacing and installation details ❑ Roof framing plan and details ❑ Fumace and hot water heater location. ❑ All header locations: type, size, and connections ❑ Foundation plan ❑ Insulation information 07/06/2008 14:39 FAX 509 927 2816 MARKHAM HOMES C 002/003 W S 00°14'56" 1 S 89°53'18" W 102.97' PROPOSED BACON'S ADDITION LOT 4 44' EN 2—CAR ss 22' ID N-) 102.94' N 89'59'33" E O N 18,123 sq.ft. 17303 E. BROADWAY 42' 22'2" � 20' 00°14' 26" W Z LEGEND 0 10 20 40 60 = LOT BOUNDARY — — — — = 8' BORDER EASEMENT 10' UTILITY EASEMENT SCALE IN FEET mawm F.0 BOX 610 IBERTY LAKE, WA 99019 (509) 927-1437 JUL 06 2006 16:06 509 927 2816 PAGE.02 07/06/2006 14:40 FAX 509 927 2616 FROM MARKHAM HOMES (2003/003 (THUI JUN 20 2000 10, 03/Gr. 1 G:02.'NO. 0 302 SrJ P 1RrnnrlR 12' MIN, 272' (TOTAL) OF PRESSURIZE° DRNNFIELDD 1' SCN. 40 PVC 12' ON CENTERS REPLACEMENT -y AREA MIN. 5' 10' MIN. 5' MIN. 7 SINGLE COMPARTMENT 1000 CALLON °°SING TANK 5' 1 DECK A' GRAVf1Y SCWCR (SEE NOTE 3) PROPOSED 3 BEDROOM HOUSE S 89463'16' W 102.97' PROPOSED BARN MIN. -. TRANSPORT PIPE. t r /OR la a S 49'S9'33' W 102.9<' 2 COMPARTMENT 1000 GAL -ON SEPTIC TANK I )C' SC1 AO PVC ORYLINE SEWER. APPROX. 90 L.F. r EASEMENT 8 2 9 EXPIRES 2-21-07 1 i-'-F-- _2•EM,— NI l^J � • 1• \\ 2 I y I I I -`PRELIMINARY ?0 . BE USED AS gINAL DA A METRO ENGINEERING, INC. 5. 324 SHERMAN SPOKANE, WA 99202 (509) 624-9351 nc\7009f1n cifR1FR15_1 Td Rwn Mntlal R/217/20OR 2a0.11 PM .h Me (1 Tan PRESSURIZED DRAINFIELD DESIGN 17303 E.BROADWAY AVENUE LOT 4, BACON'S ADDITION DRAWN BY: JKO CHECKED BY. JGL DATE: C6/29/05 PROJECT No,: 05-315 JUL 06 2006 16:06 509 927 2816 PROE.03 07/08/2006 14:39 FAX 509 927 281E MARKHAM HOMES S 89°53'18" W 102.97' Z 002/003 w CO O 0 N O' 1.6 in IP ePRESSURIZED �DRAINFIELD 1 tst 11' 17' n 102.94' 5 PODOSED 3A\ 60X 40' BACON'S ADDITION LOT 4 N 89'59'33" E O 18,123 sq.ft. 17303 E. BROADWAY 22'2" 42' ) 2 0 ' LEGEND - LOT BOUNDARY — — — — = 8' BORDER EASEMENT 10' UTILITY EASEMENT 0 10 20 40 60 NIMMI SCALE IN FEET F.0 BOX 610 LIBERTY LAKE. WA 99019 (509) 927-1437 JUL 06 2006 16:06 509 827 2816 PAGE.02 MapOptix 4.2 Interface Page 1 of 1 Tools ED .Ci Layers Query Parcel Owner Tax Selection Method: 45131.3024 0 PID: 55182.2744 _-------------- Neighborhood: Site Address: X p vk C'-"A =k O 0 45131.0214 16905 5682.. 45131.02OS 45 31.••r. s Buffer 7 Query Ratillo 1s mer --_ParceLOwneniaz.`17.l.oLLRecord,) .34.(kq; 45134.0533 PID ACO Neighborhood Site Address Site City &yN 52.E 55:' 82243 55. r 52 `S5 ' 8 L�S28222,,: �CityofS £h} 551822n9 7 17771 Site Site 551822645 Y :74235518 46 551a 553E 6 1342 Own Arlrlrr http: //dorado/mox42/index.cfrn?action=mox42_ifprism&screenHeight=531 &screen Wid... 06/28/2006 Permit Center S � .kane 11707 E Sprague Ave, Suite 106 p Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development wwnv.spokanevalley.ora.com Plumbing Permit Application o Commercial s4 idential PERMIT NUMBER: PERMIT FEE: SITE ADDRESS 3o3 Building owner _ Name: -,-Inv‘ TLrcts4 Phone: 4-cte7--. 3 T T2 Fax Address: City State Zip Contractor - Name: GSe 7::1LAM 6ivic, Phone: T-69 Fax: 4-6 -�26 -Sa(c Address: �J City State Zip License No: 6 -PL U IC PCI 4- 0 C I+ City Business License No: Contact :`: Name: r.Re-is Be(�cSPVn Phone: t g--S.a10J DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 3 X $6.00 = 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH. STALL, ON -SITE BUILT 3 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 1 X $6.00 = 7 CLOTHES WASHER I 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 X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS I X $6.00 = 15 SEWAGE EJECTOR X $6.00 = GRINDER. SUMP PUMP 16 WATER USING DEVICE ICE.AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER,CARBONATOR,SWAMPCOOLER 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: 0 CASH 0 CHECK Card# SUBTOTAL 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8126/05 S..;oO'Valley Community Development Mechanical Permit Permit Center 11707 E Spry e Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 ❑ Commercial SITE ADDRESS 3'�G� - Coq cl't/✓Fy -.___. PERIvl;TNLITT PE 3PEE o,Fesidential AUTHORIZED SIGNATURE: REVISED&2-&05 ....' Name: �-- �i �� F-�bs -t- Phone::,. LFA -3-7 ---)1- a Fax Address: City State Zip ' CDIME racibrr Name: COeO4,n/4 WCc- ~iee+l Phone qQ -o20; Fax: R7-6- 6�oqc Address: O - Citysr�-+ca e c State 'W Zi C70/ License No: City Business License No: FContaM, r. Name: IG LE Phone: o --3f- DESCRIPTION OF WORK # OF UNITS X COST - TOTAL AMOUNT 1 FUEL BURNING APPLIANCE Equal to or less than 100.000 X $12.110 - 2 FUEL BURNING APPLIANCE More than 100,000 X $15.00 - 3 UNLISTED APPLIANCE Additional Fee E ual to or less than 400,000 X $50.00 - 4 UNLISTED APPLIANCE Additional Fee More than 400.000 X $100.00 - 5 USED APPLIANCE SEC min. AFUE ratio Equal to or less than 400,000 X $50.00 - 6 USED APPLIANCE MSEC min. AFUE ratio More than 400,000 X $100.00 - 7 BOILERIREFRIGERATION 1 -100M BTU X $12.00 - 8 BOILERIREFRIGERATION 101-500M BTU X $20.00 - 9 BOILERIREFRIGERATION 501 -1.000M BTU X $25.00 - 10 BOILEZREFRIGERATION 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' - 13RANGE i, X $10.00 - 14 DRYER X $10.DD - 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 OES' NOT include ductin Greater than 10.000 CFM X $15.0022 gAIRHANDLER ATIVE COOLERS X $10.00 23 OOD ` X $50.00 24 OOD X $10.00 - 25 HEAT PUMPIAIR CONDITIONER D-3 TON X $12.00 - 26 AIR CONDITIONER 3-15 TON 1 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 560.00 - 30 LPG STORAGE TANK X $10.00 - 31 WOOD OR PELLET STOVEIINSERT X $10.00 - 32 WOOD STOVE - FREESTANDING X $25.00- 33 REPAIR 8 ADDITIONS X $15.00 - 34 VENTILATION SYSTEMS X $12.00 - 35 VENTILATION MECHANICAL EXHAUST X $12.00 - 36 INCINERATOR -RESIDENCE X $19.01 - 37 INCINERATOR -COMMERCIAL X $22.00 - METHOD OF PAYMENT: OCASH O CHECK ❑ VISA [IMC CARD #: DATE: EXPIRES: SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: $35.00 AUTHORIZED SIGNATURE: REVISED&2-&05