2005, 10-10 Permit App 05003731 AdditionProject Number: 05003731 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 10/10/2005 Page 1 of 2
Permit Use: ADDITION OF MASTER BEDROOM & Contact: RAY HARTY
BATHROOM Address: 1005 S CENTER DR
C - S - Z: SPOKANE VALLEY WA 99212
Setbacks: Front Left: Right: 44 Rear: 24 Phone: (509) 218-3364
Group Name:
Site Information: Project Name:
Plat Key: 002139 Name: REGOS ADD
District:
F
Parcel Number: 45161.0857 Block:
SiteAddress: 11617 E REGO CT
Location:: CSV
Zoning: UR 3.5
Water District:
Area: .00 Acres Width: 0
Nbr of Bldgs: 1 Nbr of Dwellings: 20
Review Information:
Lot:
Owner: Name: MOYER, TIM
Address: 11617 E REGO RD
SPOKANE VALLEY, WA 99206
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Site Plan Review
Released By:
Plan Review
Permits:
Released By:
Contractor: HARTY FENCE & DECK CO
Address: 1005 S CENTER DR Phone: (509) 218-3364
SPOKANE VALLEY WA 99212
Building Permit
Firm: RAY HARTY/HARTY FENCE & DE
Operator: CJJ
Printed By: CJJ
Print Date: 10/10/2005
Project Number: 05003731 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/10/2005 Page 2 of 2
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: CJJ Printed By: CJJ Print Date: 10/10/2005
a� Permit Center I '� i �:q'
*Wane 11707 E Spragu''nt , e, Suite 106
��\7alle Spokane Va11ey, WAS 99206
(509)688-0036 F (509)688-0037
Community Development www.spokaneva 11 v7 rg.com
Residential Construction ❑ New Construction ❑ Accessory Bldg
Permit Application < ddition/Remodel o Deck
o Other:
D
;RMITNU1 EF
Rom_
SITE ADDRESS /Y 7/ 7
ASSESSORS PARCEL NO: LEGAL DESCRIPTION:
Bilding owner ` ._.-_., r .
u
- ' ` '
, ,. -
Name:
l AI c y i.e__
Address:
// 4 t 7 g,
Q e..,--
City:. '
v Zip:rrZe�
,
Phon
? 2 — �o 6 Fax:
~on7tact Person
Name: A - ,
Phone: — '3
Describe the scope of work in detail:
ontraetor :� '--, ` ,ti .., ... ... _ .... _, n _
Name: /E A-2/ Z1-71`!K, / y
Address: &Ler S` g . & _i\7-7- .
City: -�t� e V f - Zip: q q 2-1
Phone: .. / g_33e,,c/Fax:
Lic N�?�14r`� F.3 / Exp. Date: e b
City Business Lic Now: ..7-7,4 '
Cost of Project: $_57%666
917-7 w7 A/
**************The following MUST be complete: (write N/A if not applicable)**********************
HEIGHT TO PEAK:
DIM ICON
# OF STORIES: f
(Zg
�7 TOTAL HABITABLE }SPACE:
Z�
MAIN FLOOR TO SQ.4vc;
FTG: G d <
2"" FLOOR SQ. FTG:
Ater
UNFIN BASEMENT SQ. FTG:
/(%1�,
IMPERVIOUS SURFACE
AREA: �7 6.
FINISHED BASEMENT
SQ. FTG:
GARAGE,SQ. FTG:
Ob�jA fAi
DECK/COOV,, P4TIO SQ. FTG:
305 SLOPES ON
PROPERTY:
# OF BEDROOMS:
/
CONSTRUCTION TYPE:
HEAT SOURCE:
-(sce____ r
SEWER OR SEPTIC?
S -4- k/
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. 6) Plans or additional information may be required to be submitted, and subsequently approved before
this application can be processed.
Signature s ✓ � Date /0 —7—
Method of Payment (Faxed permit applications will only be accepted with major bankcard)
❑ Cash 0 Check 0 Mastercard 0 VISA 0 Other
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
Spokane
�sValley
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 • -
Community Development www. pokanevallev.on.com
Plumbing Permit Application o Commercial
PERMIT NUMBER:
PERMIT FEE:
o Residential
SITE ADDRESS
Building owner
Name:
Phone:
Fax
Address: -
City
State
Zip
Contractor
Name:
Phone:
Fax:
Address:
City
State
Zip
License No:
City Business License No:
ContaM..
Name:
Phone:
DESCRIPTION OF WORK
# OFUNITSX
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET. BIDETS
i
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE
ITE BUILT
B
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
2
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:
0 CASH 0 CHECK
Card#
❑ VISA 0 MASTERCARD
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
Permit Center
.Valley
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.sookanevallev.org.com
Mechanical Permit Application n Commercial
PERMIT NUMBER:
PERMIT FEE:
Residential
SITE ADDRESS:
Building owner
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
Contractor
Name:
Phone:
Fax:
Address:
City
State:
Zip:
License No:
City Business License No:
Contact
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
= TOTAL AMOUNT
1
2
FUEL BURNING APPLIANCE
FUEL BURNING APPLIANCE
Equal to or less than 1.00,000
More than 100.000
X
X
$12.00
$15.00
3
4
5
6
7
UNLISTED APPLIANCE (Additional Fee)
UNLISTED APPLIANCE (Additional Fee)
USED APPLIANCE (WSEC min. AFUE rating)
USED APPLIANCE (WSEC min. AFUE rating)
BOILER/REFRIGERATION
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
X
X
X
X
X
$50.00
$100.00
$50.00
$100.00
$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
X
$10.00
15
FUEL BURNING WATER HEATER
X
$10.00
16
MISC. FUEL BURNING APPLIANCE
X
$10.00
17
18
GAS PIPING (each outlet)
DUCT SYSTEMS
X
X
$1.00
$10.00
19
VENTILATING FANS
1
X
$10.00
20
21
22
AIR HANDLER (DOES NOT include ducting)
AIR HANDLER (DOES NOT include ducting)
EVAPORATIVE COOLERS
Equal to or less than 10,000 CFM
Greater than 10,000 CFM
X
X
X
$12.00
$15.00
$10.00
23
TYPE I HOOD
X
$50.00
24
TYPE II HOOD
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
$22.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK 0 VISA ❑ MC
CARD #:
AUTHORIZED SIGNATURE:
DATE:
EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 6/26/05