2011, 10-11 Permit: 11003220 ROW, Plumbing FixturesflValley®
Permit Center
11703 E Sprague Ave Suite B3 Spokane Valley WA 99206
509.720-5240 • Fax: 509.688.0037 • email: permitcenter@spokanevalley.org
Site Information Project Information
Site Address: 422 N BURNS RD
Parcel Number: 45144.0946
Subdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: DAUENHAUER, SALLY L
Address: PO BOX 905
VERADALE, WA 99037
Building Inspector: EAST
Water Dist:
Project Number: 11003220 Inv: 1 Issue Date: 10/11/2011
Permit Use: BUILDING DRAIN CONNECTION
Applicant: NORM'S Excavating
PO BOX 574
VERADALE, WA 99037
Contact: NORM'S Excavating
PO BOX 574
VERADALE, WA 99037
Setbacks - Front:
Group Name:
Project Name:
Left: Right:
Phone: (509) 928-0580
Phone: (509) 928-0580
Rear:
1
Permits
Plumbing Permit
Contractor: NORM'S EXCAVATING INC License #: NORMSE1972BM
PROCESSING FEE
FOR PLUMBING INSPECTIONS CALL (509) 688-0054.
Right of Way
$37.00 BUILDING DRAIN CONNECTI 1 $6.00
Total Permit Fee: $43.00
Contractor: NORM'S EXCAVATING INC License #: NORMSEI972BM
ROW - NO CUT OBS CLEANUP 1 $110.00
Total Permit Fee: $110.00
FOR RIGHT OF WAY INSPECTIONS CALL
(509) 869-5373 ENGINEERING
Payment Summary
Total Fees AmountPaid AmountOwin2
$153.00 $153.00 $0.00
Tran Date Receipt # Payment Amt
10/11/2011 28670 $153.00
Processed By: BONDURANT, MICK
Printed By: MORRIS. HEATHER Page 1 of 1
PERMIT
�alley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
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Plumbing Permit Application
Mail or Fax To:
Norm's Excavating, Inc. 171
y 1 8} y lV
PO Box 574
Veradale, WA 99037
Fax: 892-0432
A06,6 U ll 'PO mull P"!"1
PERMIT NUMBER: ( 1 -37ZO
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PERMIT FEE:
n Commercial ® Residential
SITE ADDRESS: 422/424 N Burns
, 074/.6
Building owner
DESCRIPTION OF WORK
# OF UNITS
Name Dauenhauer
Phone: 891-0894
Fax:
TOTAL AMOUNT
Address: SAME
TOILETS
City: State:
Zip:
Contractor
56.00
=
6.00
Name: Norm's Excavating, Inc
URINALS
Phone: 509/928-0580
Fax: 509/892-0432
Address: PO Box 574
$6.00
City : Veradale State: WA
Zip: 99037
License No: NORMSE1972BM
TUBS
City Busincss License No:
Contact
56.00
=
Name: Sheila Gibbons
SHOWERS (PER TRAP)
Phone: 928-0580
1
AUTHORIZED SIGNATURE:
B•d ae1702Gss0S
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REVISED 8/26/05
e8S:B0 TT TT 400
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
1
X
56.00
=
6.00
2
URINALS
X
$6.00
=
3
TUBS
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
=
6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
$6.00
=
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
1
X
$6.00
=
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
56.00
=
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
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK ® VISA 0 MASTERCARD
Card# See Cover Sheet EXPIRES:
SUBTOTAL
24.00
PROCESSING FEE
TOTAL PERMIT FEE DUE:
24.00
AUTHORIZED SIGNATURE:
B•d ae1702Gss0S
2uzq.eneox3 SwuoN
REVISED 8/26/05
e8S:B0 TT TT 400
'Sine
\Talley
f7L0 'cl-1066:6 -UQ oniq PA!
Ca11 24 hours before inspection required
Phone 509.688-0195 Fax 509.688-0037
DEPARTMENT OF PUBLIC WORKS
Anticipated start date 10-27-2011 Permit # Account # 000122
ROW CONSTRUCTION PERMIT
Location of property 422/424 N Burns
(Address/Parcel #, if available)
Applicant Name Dauenahaer
Address Same Fax 892-0432
Contractor's Name Norm's Excavating, Inc.
Address PO Box 574 Veradale, WA 99037 Phone 509/928-0580
Contractor's Reg# NORMSEI972BM
Expires 01/14/13
PROJECT DESCRIPTION (Provide site sketch or plan as necessary for clarity)
Sewer Connection El Driveway
Ell Gas Installation/Repair
riSidewalk Repair/Construction
Curb & Gutter
I Cable/Conduit/Pole
Other
1
Pavement Cut Dimensions
Bond/insurance certification must be on file with the City. Bond # 103957298
SPECIAL CONDITIONS:
Permittee Signature Approved Date
hereby authorize the City ofSpokane Valley to charge the fee for this permit permitto my credit card.
Card # See Cover Sheet
Name of Holder
Expiration Date
Signature
Fees Paid$ 110-00 Date Init
(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.
Work completed satisfactorily (Signed) Date
Permit not valid until One -Call Notification Ticket # entered here
PERMIT MUST BE KEPT ON SITE
L • 01 26.0026860S 2uT4erleoxRSW..JOkI eic:nn TT TT ,Inn