2003, 07-09 Permit App: BD-03-755 Plumbing FixturesETHOD O
] CASH
Spokane
.0.0Valley
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
0 C'3--' 75
PROJECT
ADDRESS: 1 fes.141YZ,Z
%u
PERMIT
USE:
# OF UNITS
OWNER: Lc'. -(i -z
( i/19///,
PHONE (Daytime Contact):
MAILING ADDRESS:
1
TOILETS
(street)
(city/stated
(ZIP)
CONTRACTOR:
-
LICENSE #:
2
MAILING ADDRESS:
PHONE #:
--Z S /— 00sg
$6
-
(street)
(city/state)
(LIP)
PLUMBING FIXTURES
ATE: EXPIRES:
NNKCARD NUMBER:
UTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
2
URINALS
X
$6
-
3
TUBS
X
$6
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
$6
.-
7
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
i
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
4
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
CHECK
115.4
InstKatf.
— -: _....1
SUBTOTAL:
12 .00
PLUS PROCESSING FEE:
$35.00
IN ■
TOTAL PERMIT FEE DUE:
.,\1 00
ATE: EXPIRES:
NNKCARD NUMBER:
UTHORIZED SIGNATURE:
City of PERMIT # leAr 03-6 I
SPOKANE VALLEY -4
UTILITY RIGHT — OF — WAY APPLICATION AND PERMIT
PUBLIC WORKS DEPARTMENT Date project starts
Date Project ends
(Please call for final inspection)
APPLICATION
Location of property involved (or address) /'S f%i FAW %
,c&
Name of company
Address of company
Contractors name
Contractors address
fr -) it c71T21ho
phone 27 -cc67/
t / phone 2 57-Ssys-g
Contractors registration Number I— t- 1 '-2..Ge
Right of Way:
Pavement or sidewalk intrusive. Yes No
Intrusive outside of pavement or sidewalks. Yes No
Length of cut ft. Depth of cut ft. Width of cut ft.
Direction of cut
Expiration date-/—e.y`
Contact person
Address of contact
Please explain in detail the description of the activity proposed.
Phone
I hereby authorize the City of Spokane Valley to charge this permit fee to my charge card.
Visa mastercharge
Print name of holder Signature
Valid Date
PERMIT:
Restoration: Permanent
Type of back fill to be used: gravel Crushed
Temporary
CDF
IS A COPY OF A BOND DEPOSITED WITH THE CITY OF SPOKANE VALLEY ?
A COPY OF THE CITY / UTILITY LIABILITY INSURANCE POLICY MUST BE ON
FILE AT THE CITY.
PERMIT FEE $ flv - Q�
Approved
INSPECTION FEE $
�-1 OS
-Public Works 1 'rector Date
CALL 24 HOURS BEFORE INSPECTION NEEDED
Phone 509-688-0036 Fax 509-688-0037
R—O- WAPP.
Site Information
Project Information
Site Address: 1305 N FARR RD
SPOKANE, WA 99206
Parcel Number: 45172.0414
Subdivision:
Block: Lot:
Zoning: UNK Unknown
Owner: BAGLEY, GILBERT W & LINDA K
Address: 1305, N FARR RD
SPOKANE, WA 99206-4050
Building Inspector: BOBBY STONE
Water Dist:
Project Number: 03004818 Inv: 1 Issue Date:
Permit Use: SEWER CONNECTION - MISSION
Applicant: ACME EXCAVATING
3021 N LILY RD
SPOKANE, WA 99212
Contact: ACME EXCAVATING
3021 N LILY RD
SPOKANE, WA 99212
Setbacks - Front: Left:
Group Name:
Project Name:
Right:
7/8/2003
Phone: (509) 228-0691
Phone: (509) 228-0691
Rear:
Permits
Sewer Connection Permit
Contractoai ACM EXCAVATING
License #: ACMEE**982LD
SEWER CONNECTION
FOR SEWER INSPECTIONS CALL (509) 477-3604 UTILITIES
Call for inspection prior to cover. ONE WORKING DAY NOT
Contractor or applicant is to field locate and confirm the elevatib
Sewer stubs are to be checked prior to connectionto ensure that
Sewer lines should be constructed to allow for gravity flow from xtheibVI st
This permit must be presented to the job site inspector for v tiny T I
CALL BEFORE YOU DIG, (509)456-8000.
STATE LAW RCW 19.122 REQUIRES THAT PRIi
NOTIFIED. CALL BEFORE YOU DIG AT LEA
Spokane County Code fequires the installer comp
those related to trench safety. i
1 $85.00 PROCESSING FEE
Total Permit Fee:
v1 MONDAY THRU FRIDAY
sewer stub prior to any other excavation.
eptable grade and are clear and unobstructed to the main sewer.
evel of the structure.
ate:,: a' d cables, gas piping, water lines, etc.
$15.00
$100.00
IAYS
mots
ALL BEFORE YOU DIG" CENTER BE
09)456-8000.
to Dept of Labor and Industries, including
Total Fees AmountPaid
$100.00. $100.00
AmountOwin. .
$0.00
Tran Date
7/8/2003
Processed By: SHATTO, JULIE
Printed By: WENDEL, GLORIA Page 1 of 1
Receipt #
4285
Payment Amt
$100.00
PERMIT