2006, 01-18 Permit App: 06000135 Sewer Reversalspa
y
Community Development
renmi t.enLer
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
w ww.s0okanevallev.ora.com
Plumbing Permit Application
SITE ADDRESS:
T NUMBER: 0/33
❑ Commercial Residen,alL
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Building owner
# OF UNITS
IL
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Name:/
1
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Phone: �' —c�
Fax: ��
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Address: �QC3 L
$6.00
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City State:
uV
Zip: \1
Contractor
rej c s
-,,,,, ,40 1 k
-
$6.00
Name:
3
Phone:
Fax:
Address:
X
$6.00
=
City : State:
Zip:
License No:
BATH, STALL, ON-SITE BUILT
X
_ City Business License No:
=
Contact
, or -- 1-,...„
E
'
1 :. _. ; r...'Name:
X
$6.00
=
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Phone:C). I -ci'i% ' 7
AUTHORIZED SIGNATURE:
REVISED sa6/Os
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
B
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
B
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/D -• TE,
VENT, PLUMBIN
NSTALLATION, ALTERATION, REPAIR,/
REVERSALS
1
X
$6.00
=
-
15
SEWAGE EJECT
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 HECK
Card# , /
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00
L.____-•._. EXPIRES: /1
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED sa6/Os
I
SPOKANE COtNIY
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Project Information
Site Address: 521 S EVERGREEN RD
Parcel Number: 45232.0420
Subdivision: GREEN VALLEY ADD
Block: Lot:
Zoning: AGS
Owner: SINES, ART
Address: 521 S EVERGREEN RD
SPOKANE, WA 99216
Building Inspector: None
Water Dist:
Project Number: 06000180 Inv: 1 Issue Date: 1/11/2006
Permit Use: SEWER CONNECT, VERA TERRACE
Applicant: BAILEY'S CONSTRUCTION
E. 3707 28TH
SPOKANE, WA 99223
Contact: BAILEY'S CONSTRUCTION
E. 3707 28TH
SPOKANE, WA 99223
Phone: (509) 532-0705
Phone: (509) 532-0705
Setbacks - Front: Left: Right: Rear:
Group Name:
Project Name:
Permits
Sewer Connections Permit
Contractor: BAILEY'S CONSTRUCTION License #: BAILEC'088JW
SEWER CONNECTION 1 $85.00 PROCESSING FEE
I $15.00
Total Permit Fee: $100.00
FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO
COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL
INSPECTION FEES APPLY AFTER 30 MINUTES.
THE INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND
MAY BE REQUIRED TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION.
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY HAVE ACCEPTABLE GRADE
AND ARE CLEAR AND UNOBSTRUCTED TO THE MAIN. SEWER LINES SHOULD BE CONSTRUCTED TO ALLOW FOR
GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE.
THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME.
BOTH STATE LAW RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
CALL 1-800-424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE
REQUIRES THE INSTALLER COMPLY WITH ALL REQUIREMENTS OF THE WA STATE DEPT OF LABOR & INDUSTRIES,
INCLUDING THOSE RELATED TO TRENCH SAFETY.
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date
1/11/2006
Processed By: Hansen, Tom
Printed By: WENDEL, GLORIA Page 1 of 1
Receipt #
150
Payment Amt
$100.00
PERMIT