1999, 10-26 Permit App: 99010326 SewerProject Number: 99010326 Inv: 1
•
r Application
THIS IS'NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 10/26/19 Page 1 of 1
Project Information:
................................................................................ ...............................
Permit Use: SEWER CONNECTION (CHESTER FIELD) Contact: ARMSTRONG CONSTRUCTI
Address: PO BOX 14282
C - S - Z SPOKANE WA 99214
Phone: (509) 928 -0559
Setbacks: Front Left: Right: Rear:
Site Information:
Plat Key: 000000 Name: UNKNOWN District: F
Parcel Number: 45332.2503
SiteAddress: 11122 E ALOHA CT
Spokane, WA USA 00000
Location:: SPO
Zoning: UR -3.5 Urban Residential 3.5
Water District:
Area: 12,979 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Owner: Name: HURST, THOMAS G & CINDY
Address: 11122 E ALOHA CT
SPOKANE, WA 99206 -5955
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Department Review
UTILITIES Review by Utilities
Comments:
Permits:
Contractor: ARMSTRONG CONSTRUCTION
Address: P 0 BOX 14282
SPOKANE, WA 99214
Description
SEWER CONNECTION
PROCESSING FEE
Sewer Permit
Firm: ARMSTRONG CONSTRUCTION
Phone: (509) 928 -0559
Units Unit Desc
1 NUMBER OF
1 Y OR BLANK
Fee Amount
$85.00
$15.00
Permit Total Fees: $100.00
PaymentSummary: .:::::..::.................................................................................... ...............................
Operator: DMD Printed By: DMD Print Date: 10/26/1999
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Sewer Permit $100.00 $100.00 $0.00 $100.00
Notes:
$100.00 $100.00 $0.00 $100.00
PLUMBING PERMIT APPLICATION
PROJECT ADDRESS:
OWNER:
PHONE: DAYTIME CONTACT
MAILING ADDRESS:
CONTRACTOR: \ D p ,m)11,1 N CT
(street)
(city/state)
(zip)
LICENSE: YO U P>fr 033 j ✓v\
PHONE:
MAILING ADDRESS: (-1 1Al4E 4
(street) (city/state)
(zip)
PLUMBING FIXTURES
DESCRIPTION DETAIL
# OF
UNITS
MULTI-
PLIED BY
COST
/UNIT
B;OZ TOILETS
WATER CLOSETS, BIDETS
x
$6
EQUALS
$
AMOUNT
URINALS
TUBS
x
$6
BATH, JACUZZI, SPA, GARDEN
x
$6
SHOWERS (per trap)
SINKS
BASE, STALL, ON -SITE BUILD
x
$6
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD (PREP /CULINARY/MEAT)
x
$6
DISHWASHER
x
$6
$
i30:: CLOTHES WASHER
$6
GARBAGE DISPOSAL /GRINDER
WATER SOFTENER-
x
$6
x
$6
ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank, see mechanical)
x
$6
FLOOR DRAINS
AREA, CASE, COI., TRENCH, CONDENSATE
x
$6
ROOF DRAINS /OVERFLOW DRAINS
FOUNTAINS, DRINKING
x
$6
x
$6
WATER PIPING/DRAIN- WASTE -VEN
PLUMBING REVERSALS
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
x
$6
SEWAGE EJECTORS
GRINDER, SUMP PUMP
x
$6
$
WATER USING DEVICES
ICE AND /OR COFFEE MAKER,
HOSE BIB. STEAMER, PROOFER,
CARBONATOR, SWAMP COOLERS
x
$6
CROSS - CONNECTION DEVICES
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, SUMPS,
TANKS, BOILERS, & SPRINKLER SYSTEMS
x
$6
$
INTERCEPTORS
GREASE TRAP. SAND TRAP,
CHEMICAL HOLDING TANK
x
$6
$
MEDICAL GAS (per outlet/bottle station)
132 MISCELLANEOUS FIXTURES
NITROUS, OXYGEN
x
$6
$
x
$6
$
NOTE: MINIMUM PERMIT FEE IS $35.00
❑ RESIDENTIAL ❑ COMMERCIAL
SIGNATURE:
Spokane County Division of Building & Planning
1026 W. Broadway Avenue * Spokane, WA 99260
Tel. No. (509) 456 -3675 * Fax No. (509) 324 -3198 * TDD No. (509) 324 -3166
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
111 /14')6 4nas1<rlpiumpermhnd
Subtotal
PLUS: PROCESSING FEE
$25.00
TOTAL PERMIT FEE DUE
Spokane County Division of Utilities
SEWER CONNECTION PERMIT
APPLICA'T'ION FORM
ci9- io32
PLEASE NOTE: This application form must be filled out accurately and in its entirety, and signed, or a permit will not be issued.
Also note that sewer permits are valid for 12 months from the date of issuance. 'No extensions will be granted.
PROJECT INFORMATION
Job address:
1! // tc'�,,
Dry Line
Sewer? (Y/N)
City:
Zip:
Parcel number (if known
26b3
Owner's name =�
7��Qi�-
City /State:
Zip:
Phone:
( 1 7 / - J
First -time contractors or home - owners performing the installation must first contact the utilities department (in person or via phone
[456 - 3604]) before a permit can be issued. _
Name of Utilities Division person contacted:
CONTRACTOR INFORMATION
Contractor (company name):
CONSY e..UCT1 zA
Business address:
City /State: S _
Zip: qck LI Phone: 92x (1551
J L4
State contractor license number:
Pt Tc Ni
Contact Name:
Phone:
INTERIOR PLUMBING ALTERATIONS? (yes circle one
Fill out the in ormation in the table below i licable **
Contractor (if d' rent from above):
N CXXNG l_Ulv\t I iVC�
Business Address:
Phone:
City /State/Zip:
** For.:plumiirngreversal, ee iii
on, seereversestde b ts
FEE INFORMATION
Sewer Connection: Number of Buildings X(times) $100 (per bldg) = $ /)
TOTAL FEE
• For a single-family residential unit, one permit is required;
• For a condominium, townhouse, duplex, triplex or fourplex with separate ownership (as determined by lot lines) separate
address and separate stub, one permit is required per address per stub;
• For a single building duplex, triplex or fourplex with single ownership, one permit is required
• Multiple buildings (apartments, industrial complexes) with single ownership, one permit required per building connecting to
the sewer.
(For situations not covered here, call the County S ' ision of Utilities @ 456 -3604)
APPLICANT SIGNATURE:
Date: %
Return to:
Spokane County Division of Building & Planning
West 1026 Broadway Avenue * Spokane, Washington 99260
PHONE: (509) 456 -3675 * FAX: (509) 324 -3198 * TDD: (509) 324 -3166
Spokane County does nor dtsmsnu:ace on the basis of .. _.e -won o of cntrnatt 01 employment ut, in ptogzanu 01 activities.
10 /1e /N < \....<..n...e pia