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2005, 05-25 Permit App: 05001760 ROW, Plumbing ReversalSpoikan` ,,,Walley Call 24 hours before inspection required Phone 509.688-0195 Fax 509.688-0037 DEPARTMENT OF. PUBLIC WORKS Q5-) 9190 Anticipated start date Permit # ROW CONSTRUCTION PERMIT Location.of property I \ se5LMr` //(Address/Parcel #, If available) Applicant Name Jody SAv,rhe-i - Fax Address 1 ( / I Phone Contractor's Name C ler . Address 30, / (vl) ,/ �� Phone 27/ PC)sc Contractor's Reg.# Expires PR CT DESCRIPTION (Provide site sketch or plan as necessary for clarity) 1 Sewer Connection Driveway O Curb & Gutter n Gas Installation/Repair ❑ Cable/Conduit/Pole n Sidewalk Repair/Construction fl Other Dimensions Q Water Iristallatton/Repair ❑ Pavement Cut Bond/insurance certification must be on file with the City. Bond # Permittee Signature Approved Date I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card. Card # Expiration Date Name of Holder Signature Fees Paid$ (Application) (Inspection) In addition to the permit application fee of $16.00 (utility) or $25.00 (construction), inspection on each permit will be billed to the permittee at a rate of $50.00 per hour with a $25.00 (1/2 hour) minimum. Permittee signature constitutes an agreement to these terms and provisions. Date !nit Work completed satisfactorily (Signed) Permit not valid until One -Call Notification Ticket # entered here Date PERMIT MUST BE KEPT ON SITE Excerpts from Spokane Valley Standards (3.24, and details A8 and A -8a): • Every driveway approach must provide access to an off road parking area located on private property. The driveway shall be of sufficient length so a vehicle In the driveway does not project into the road right of way, sidewalk, or pathway. • Public or private driveways in industrial, commercial, multiple family, church or any like use shall be constructed to allow vehicles to exit without backing onto a public road. • Driveway approaches shall be constructed to avoid interference with existing drainage inlets, culverts, road lighting standards, utility poles, traffic regulating devices, fire hydrants or other public utilities. The applicant shall bear the cost of relocating any such public facility. • Driveway approach grades within the right of way shall not exceed 8% in urban area, or 2% in rural areas. Driveway grades shall not exceed 10% within ten feet of a city right of way. See Standards for a more complete listing of requirements. PLUMBING PERMIT APPLICATION DC Phone: (509) 688-0036; FAX: (509) 688-0037 elkY For Inspections, Call (509) 688-0054 Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Project Address: j )5-03 6 6,,oar Permit Use: Owner. ,,, . f�.,cI,,---u Phone (Daytime Contact): Mailing Address: j 1 5-0" E 3,n l. -,- State Zip Code Phone #: Contractor. 14-ri-,f FiGL, c;z/2 City License #: Mailing Address. 2 / y ) Illy Ito �J. c L State Zip Code BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTOR OF WORK S OF UNITS X COST = . TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X 16.00 = 2 URINALS P X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP} BATH, STALL, ON-SITE BUILT 5 X $6.00 = 5 SINKS LAVSIBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT ' X $6.00 = 6 DISHWASHER X 16.00 = 7 CLOTHES WASHER X 86.00 = 8 GARBAGE DISPOSAL X 16.00 = 9 WATER SOFTENER X 86.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 16.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 16.00 = 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 A X 86.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 86.00 = 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 86.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X 16.00 = 21 PRIVATE SEWAGE DISPOSAL/SYS X 120.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: • 0 CASH 0 CHECK DATE 0 VISA 0 MASTERCARD SUBTOTAL PROCESSING FEE 135.00 EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: