2005, 05-12 Permit App 05001568 Duplex, GaragesProject Number: 05001568 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Permit Use: NEW DUPLEX W/ATTACHED GARAGES -
NATURAL GAS
Setbacks: Front
Site Information:
Le
Contact: ENGEBRETSON, JOHN
Address: 111 W ROLLAND AVE
C - S - Z: SPOKANE, WA 99218
t: /0,S Rear:f 9 Phone: (509) 467-4011
Group Name:
Project Name: ROW
Plat Key: Name: RANGE
Date: 05/12/2005 Page 1 of 4
(-a-00
CQS
District: East
Parcel Number: 45134.0207 Block:
SiteAddress: 16810 E BROADWAY AVE
Location:: CSV
Zoning: UR-3.5 Urban Residential 3.5
Water District:
Area: 0 Sq Ft Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 1
Review Information:
Site Plan Revie
Plan Review
Lot:
Owner: Name: ENGEBRETSON, JOHN
Address: 111 W ROLLAND AVE
SPOKANE, WA 99218
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Released By:
Gyjeliniuv
Approach / Drainage
Released By:
Septic System Review
Released By:
ate.
Landuse/Zoning
Released By:
Operator: K_C Printed By: K_C Print Date: 05/12/2005
05/17/05 11:13 ' 509 324 3603
FROM :E FISHER PE
SP0 REGIONAL HEA
FAX NO. :509 927 0120 May. 13 2005 08:0'Qtl P2
(i2]001
Project Nmnbrr. 05001568 Inv t
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
•
Proiect Information:
Permit Use: NEW DUPLEX W/ATTAGRED GARAGES -
NATURAL GAS
Setbacks: Prom Left Right Rear:
Site Information:
Plat Key: Name: RANGE
Date' OS/12/2005
Contact ENGEBRETSON, JOHN
Address: 111 W ROILAND AVE
C - S - Z: SPOKANE, WA 99218-
Phone: (309) 467-4011
Group Name: S7o YtoB
Project Name: ROW
Page 1 of 4
tantaarmoacearama
ate
District East
Parcel Number 45134.0207 Block
SiteAddress: 16810 E BROADWAY AVE
Location:; CSV
Zmung:, 1711-3.5
Water District:
Area 0 Sq Ft •Width: 0
Nbr of B1dgs: 1 NM' pf Dwellntgs: 1
Review Information: mestemaanammeniamantesanaseasesememe
Review
Site Plan Review
Plan Review
Approach / Drainage
Septic System Review
Urban Residential 3.5
Lot:
Owner: Name: ENGEB1tETSON, JOHN
Address: 111 W ROLLAND AVE
SPOKANE, WA 99218
Hold: ❑
Depth: 0 Right Of Way (ft): 0
flea t5
MAY 17 2005 12:37
509 324 3603
PAGE.01
Project Number: 05001568 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Septic System Review
Date: 05/17/2005 Page 2 of 4
Released By:
OK PER D COPLEY SEPTIC DESIGNED FOR 4 BEDROOMS
Originally Released: 05/17/2005 By: KCUMMIN
Landuse/Zoning
Permits:
Released By:
PRELIM SHP-14-05 (FIRST HOUSE) SEE PERMIT CONDITION
Originally Released: 05/17/2005 By: kcummings
Approach
Contractor. OWNER Firm: OWNER
Phone: (000)000-0000
Item Description
APPROACH INSPECTION
CONST IN ROW - APPROACH
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
Fee Amount
$25.00
$25.00
Permit Total Fees: $50.00
Operator: K_C Printed By: K C Print Date: 05/17/2005
Project Number: 05001568 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Contractor: OWNER
Group: R-3 Type: VB
Total Area 4312
Building Height 22
Stories 1
Dwelling Units 2
Building Permit
Date: 05/17/2005 Page 3 of 4
Firm: OWNER
Phone: (000) 000-0000
Building Characteristics
Description Grp Type Notes
BASEMENT U R-3 VB
GARAGE U-1 VB
RESIDENCE R-3 VB
Item Description
RESIDENTIAL PERMIT FEE
STATE SURCHARGE
RESIDENTIAL PLAN REVIEW
Contractor: OWNER
Item Description
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
GAS LOG OR GAS INSERT
HOOD -TYPE II
This Application:
Sq Ft Valuation
1,256 $18,840.00
760 $14,440.00
3,056 $228,222.08
Tcals: 5,072 $261,502.08
Units Unit Desc
1 SELECT
1 SELECT
1 SELECT
Permit Total Fees:
Mechanical Permit
Firm: OWNER
Phone:
Units Unit Desc
2 NUMBER OF
2 NUMBER OF
6 # OF UNITS
8 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Total Project:
Sq Ft Valuation
1,256 $18,840.00
760 $14,440.00
3,056 $228,222.08
5,072 $261,502.08
Fee Amount
$1,900.95
$4.50
$760.38
$2,665.83
(000) 000-0000
Fee Amount
$20.00
$24.00
$6.00
$80.00
$20.00
$20.00
$20.00
$190.00
Operator: K C Printed By: K_C
Print Date:
05/17/2005
Project Number: 05001568
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Inv: I
Contractor: OWNER
Item Description
TOILETS/BIDETS
SINKS
TUBS
DISH WASHERS
CLOTHES WASHER
WATER USING DEVICES
Plumbing Permit
Date: 05/17/2005
Page 4 of 4
Firm: OWNER
Phone: (000) 000-0000
Units Unit Desc
6 NUMBER OF
6 NUMBER OF
4 NUMBER OF
2 NUMBER OF
2 NUMBER OF
2 NUMBER OF
Fee Amount
$36.00
$36.00
$24.00
$12.00
$12.00
$12.00
Permit Total Fees: $132.00
Notes:
POOL AT 16806 E BROADWAY MUST BE REMOVED OR ALTERED TO MEET SETBACKS OR
AN EASEMENT BE GRANTED AND RECORDED PRIOR TO CERTIFICATE OF OCCUPANCY
OF THIS DUPLEX.
POOL AT 16806 E BROADWAY MUST BE REMOVED OR ALTERED TO MEET SETBACKS
OR AN EASEMENT BE GRANTED AND RECORDED PRIOR TO CERTIFICATE OF
OCCUPANCY.
Payment Summary:
Permit Tvpe Fee Amount Invoice Amount
Approach $50.00 $50.00
Building Permit $2,665.83 $2,665.83
Mechanical Permit $190.00 $190.00
Plumbing Permit. $132.00 $132.00
$3,037.83 $3,037.83
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$2,665.83
$190.00
$132.00
$0.00 $3,037.83
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: K_C Printed By: K_C Print Date: 05/17/2005
Spokane
jUalley
D
cs--/9,2g
BUILDING PERMIT APPLICATION WORKSHEET
City of Spok. • - 1Valley Community Development Department
tAY 10 2005
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
ne: (509) 688-0036; Fax: (509) 688-0037
OD 1§'ItE' INFORMATION
Street Address: /673h15 F, fi cishi) j
Assessor's Tax Parcel Number(s): 4'5 `' �c7(j ( PT71
Legal Description: }- FAc
PERMIT DESCRIPTION: >�t���
Building Permit
Relocation
7 Change in Use ❑ Grading
❑ Manufactured Home
Tenant Improvement ❑ Fire Safety Other
OWNER/APPLICANT INFORMATION
[2jv Owner: John Z' Applicant:
Phone: r 7-Vi// Fax: Phone:
Address: /// //). j's'oLLi4i-zn ,�t)E__ Address:
State
Contractor:
Phone:
Fax:
Zip Code City
Address:
Fax:
City
State Zip Code
WA State Contractor License #:
Architect:
Phone:
State Zip Code
Address:
Fax:
City
Contact:
State
Zip Code
PERMIT/BUILDING INFORMATION
HEIGHT TO PEAK:
•, .
DIMENSIONS: ,
y3
# OF STORIES:
MAIN FLOOR TO SQ. FTG:
7;/(7
,Z'y��
2 ° FLOOR SQ. FTG:
X.)f
UNFIN BASEMENT SQ. FTG:
/0.5('c
FINISHED BASEMENT SQ. FTG:
AS
GARAGE SQ. FTG: .
DECK/COV. PATIO SQ. FTG:
OCCUPANCY GROUP:
CONSTR
CTION'TYPE:
cNi�1 s i-tc..1
HEAT SOURCE: .
Gft5 ioirP'is2,r
IMPERVIOUS SURFACE AREA:
-
# OF BEDROOMS:
,-1
TOTAL HABITABLE SPACE:
• r.) s7r--
COST OF PROJECT:
.2,-7/'_77`•�_-- , e',c7
30% SLOPES ON PROPERTY:
2
SEWER OR ON -SITE SEPTIC
SYSTEM? SFDz`i C
MANUFACTURED HOME
Width:
Length: Year: Pit Set:
Manufacturer:
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
Inspector: Phone: Fax:
Address:
Zip
City
State Zip
SPECIAL INSPECTIONS
BOLTING [�] CONCRETE I I REINFORCEMENT _ WELDING
Firm Name:
Phone:
I nspector(s):
Fax:
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 i the propert
Print Name Signature
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash
Bankcard #:
Authorized Signature:
Check
(l Mastercard
P1 Other
❑ VISA
Expires:
VIN#:
Contractor:
PLUMBING PERMIT APPLICATION
.e Phone: (509) 688-0036; FAX: (509) 688-0037
diValky For Inspections, Call (509) 688-0054
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Project Address: /7rRO(r, E E. ! 0cLJ I,,) f f Permit Use:
Owner: Sr-'i\'n F nyc%b r(1l ` '`�
Mailing Address: /// /,_9, I () L? 4)ff) j/ll)E- : 1 c in 1
State Zip Code
License #: Phone #:
Mailing Address:
City
Phone (Daytime Contact): 1'�� — F96
City
Sta
D
DESCRIPTION OF WORK•#
OF UNITS
X
COST -
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS '
x
56.00.
=
3(.
, .
2
URINALS
.
X
$6.00
=
3
TUBS
"'
y
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
56.00
• LAVS/BASINS, BAR, FLOOR,
5
SINKS
KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD. PREP/CULINARY MEAT
X
56.00
=
3ii.
6
DISHWASHER
z
X
56.00
=
7
CLOTHES WASHER
2
X
56.00
=
y7
1 Z
8
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS. SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE. COIL, TRENCH, CONDENSATE
_
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS ]
X
56.00
=
13
FOUNTAINS, DRINKING
_
X
56.00
=
WATER PIPING/DRAIN-IN WASTE,
NSTALLATION, ALTERATION,
14
VENT, PLUMBING. REVERSAL
REPAIR,
• REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
2
X
56.00
=
I L-
VACUUM BREAKER,
17
CROSS CONNECTION DEVICE
CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
56.00
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
_
X
56.00
20
MISCELLANEOUS PLUMBING•
FIXTURE
X
$6.00
-
=
•
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
=
INDUSTRIAL WASTE
22
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
SUBTOTAL
____
El CASH HECKPROCESSING
0 VISA 0 MASTERCARD
FEE
• DATE: •5f l7"/7 S EXPIRES:
; 535.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: ,/1 /
/
Project Address:
Owner.
Mailing Address:
MECHANICAL PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, Call (509) 688-0054
Community Development Departrnen1
Building Divisior
11707 E. Sprague Avenue, Suite 10E
Spokane Valley, WA 9920E
Permit Use:
Phone (Daytime Contact):
City
Contractor: License #: Phone #:
Mailing Address:
State
State
Zip Code
Zip Code
D
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
0.2-
X
542.00
=
alki
2
FUEL BURNING APPLIANCE
More than 100,000
X
515.00
=
3
UNLISTED APPLIANCE (Additional Fee)
Equal to or less than 400,000
X
550.00
=
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
5100.00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400,000
X
550.00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X '
5100.00
=
7
BOILER/REFRIGERATION
1 - 100M BTU
X
512.00
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
=
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
525.00
=
10
BOILER/REFRIGERATION
1,001-1,750M BTU
X
535.00
=
11
BOILER/REFRIGERATION
More than 1,750M BTU
X
560.00
=
.___
12
GAS LOG, GAS INSERT, GAS FIREPLACE
0-
X
510.00
=
G•6
13
RANGE
X
510.00
=
14
DRYER
X
510.00
=
'
15
FUEL BURNING WATER HEATER
X
510.00
=
16
MISC. FUEL BURNING APPLIANCE
X
510.00
=
17
GAS PIPING (each outlet)
•
X
r
$1•.00
=
18
DUCT SYSTEMS
X
510.00
=
19
VENTILATING FANS
•
S
X
510.00
=
PO
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM .
X
512.00
=
•
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
S15.00
=
22
EVAPORATIVE COOLERS
X
S10.00
=
23
TYPE 1 HOOD
, X
550.00
=
24
TYPE II H000
a_
X
510.00
=
b -
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
CONDrr_IONER .
3-15 TON
X
520.00 •
,=
27
.AIR
AIR CONDITIONER
15-30 TON
X
525.00
= .
_
26
AIR CONDITIONER
30-50 TON
X
535.00
=
29
AIR CONDITIONER
More than 50 TON
X
560.00
=
30
LPG STORAGE TANK
X
510.00
=
31
WOOD OR PELLET' STOVE/INSERT •
X
510.00
=
32
WOOD STOVE - FREE STANDING
X
S25.00
=
33
REPAIR & ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
• 512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
512.00
=
36
INCINERATOR - RESIDENCE ?
X
519.00
=
_
37
INCINERATOR - COMMERCIAL
X
522.00
=
.
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA ❑ MC
,,..,,. u ..
DATE:
SUBTOTAL
/Afq
PROCESSING FEE
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
PROPERTY DESCRIPTION
PROPOSED LOT "2"
That portion of the East half of Tract 2 of Vera, as per map thereof recorded
in Book "0" of Plats, Page 30, in the office of the County Auditor, Spokane
County Washington, described as follows:
Begin at the NE corner of said Tract 2 of Vera; thence N89°52'07"W along
the North line of said Tract 2 of Vera and the South Right of way line of
Broadway Avenue, 40.00 feet to the True Point of Beginning; thence
SOO°25'37"E, 110.35 feet; thence S38°27'28"W, 76.22 feet; thence
N89°52'07"W, 72.16 feet to a point on the West line of the East'h of Tract
2 of Vera; thence N00°25'37"W, 170.54 feet to the North line of said Tract
2; thence S89°52'07"E, 120.01 feet to the TPOB.
(L'[fet2 & 5/)er4T10N)
N
S89'52'07"E 160.01
West line of the East 1/2
of Tract 2 of Vero
cos Ilne
GARAGE
HOUSE 6 Paal
6Z'1b9 M„L,SZ.00N
3„LC,SZ.00S
Peel to be removed
TRACT "A"
TRACT "B"
30'
LJ
m
73
0
O
L
s
O� Cu
0)
C,a
N
N N
N
TRACT "C" co
50 100
N 89'53'42"W
1 gr.) n1
Proposed Short Plat
200
r\
11111/
Founded 1946
impson Engineers, Inc.
CIVIL ENGINEERS & LAND SURVEYORS
N. 909 ARG❑NNE ROAD, SP❑KANE WA., 99212-2789
PHONE (509) 926-1322 FAX (509) 926-1323
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160.01
CITY OF SPOKANE VALLEY
PRELIMINARY SHORT PLAT
THE SE I14 OF SEC-13, T25N, R44 EWM
CITY OF SPOKANE VALLEY, WASHINGTON n..n__..
PROPERTY DESCRIPTION
ll" West 160 feel of Me East half of Trost 2 el W.. aaonn,q to plot
..d.d b V"'mf '0' of Plats. P490 .RI, N SpoMant Oaml% Washington.
EXCEPT that portion combed as holders:
8-914 at Me D North, line of e ME �r Id Troot 2 OfVua and Me 2 of Verdi, atwaySauthRight ofs of
BfoodFay Avenue, 40.00 feel to M. Tms Point of Beg r.M, IAma
Mence
IQUO , 7Ple feet feet,o a PON/ athemad o Me W t the Of76.22 theCast 1/2'of
Tlaot 2 of Vmo; Mena N0096'37'Wth
, 170.34 test to e North IN. of Bald
Tfoei 2. Mmw SBOV'07% 120.01 feet to Me TPOB.
Prapefty Description from Bt,k "corded at Me Coanly Auditor
SITE DATA REMARKS
[Fsnxo iorc
uR-3s
.an SsoU fn t' 101.
3
sFltu 107 aA
11flCu MY SRCHTASC
VM,.
wyA M[A 6 nAT
tf3 Ao.
0W.FA
Ave, a uwry f"mm
wood E. f,wOw/ Aw.
Splsu Vyt%1p ffJS)
f31-)SSf
alsms AP.'
111f Rtl"N A.t
SpYm4 Vt Mi1B
93]-SMN
SNRTMY SENfR
gMlk
CSTS MA1iR
fGA FAIL 1, Faf[R
NOTE:
Pan to e.1 .m.e
M1q"IF 1, rMe1M1Y b4 %ne. mwa a..n . M yqt
)Lary rv! rye [mL awet .Y "n., baNef! ..H. aM efilktl Lee, t! q ln,f F I,n Ulkp Yle, 6Snma
VC ITY YAP
FemM! IfN
9 imps
CIVIL NE on 8ngineers, Inc.
N. 909 A GONNEI RO DS SPOKANE VA., 9999212-2789
PHONE (S09) 926-1322 PAX (609) 926-1323
FROM :E FISHER PE
ADDRESS
ZONE ROAD WIDTH r r):i d �t
FRONT ) FLANKING
COMMENTS •
REVIEWED SY
This site plan is being
litilaining a building permit
. Mien of the 111111111111111•Mions curb line: -
have been Also
bodies of wit r, Rep lope:.
Date.'.
"t •
.l• I"
.{ • •
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