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2003, 06-05 Permit App: BD03-253 Plumbing MechanicalHOD OF ASH lan or ane 4;00Valley 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax Plumbing Permit Application PROJECT _Z-eA;?)Z DESCRIPTION PERMIT # OF UNITS ADDRESS: Z fir- USE: AMOUNT OWNER:.-�`� J �� PHONE (Daytime Contact): 2� Z MAILING ADDRESS: X (street) (city/state) (ZIP) CONTRACTOR: Q E LICENSE #: ' v, . . 2 ,� MAILING ADDRESS: PHONE #: (street) (city/state) (ZIP) PLUMBING FIXTURES LCARD NUMBER: IORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST'IEQUALSI AMOUNT ETS WATER CLOSET, BIDETS Z X $6 - O� ALS X $6 - t4SEOWERS L, X $6 _ 40 (PER TRAP) BATH, STALL, ON-SITE BUILT �- X $6 -S 12 eo0w LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- X $6 = �r RAY, FOOD, PREP/CULINARY/MEAT Z41 6 DISHWASHER l X $6 - �-- 7 CLOTHES WASHER X $6 6 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 3 X $6 - 12 FOUNTAINS, DRINKING -- X $6 - 13 WATER PIPING/DRAIN-IN INSTALLATION, ALTERATION, REPAIR, WASTE, VENT, PLUMBING REVERSALS -- X $6 ---- -------_— - —__ _ _ REVERSAL 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, X $6 - SWAMP COOLER / 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 -!s 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK -""— X $6 - 19 MEDICAL GAS per outlet NnROUS, OXYGEN — X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT SUBTOTAL: A? PLUS PROCESSING FEE: $35.00 YEA ] CHECK ❑ ❑ :___.�___-.. TOTAL PERMIT FEE DUE: avnT n � c. LCARD NUMBER: IORIZED SIGNATURE: W6ne l Ualley Mechanical Permit Application PROJECT Z"4.'Riz vi�jlr�rV,r �l� GtT PERMIT ADDRESS: G� •� USE: OWNER:? A AIL % A0rAZ )S. PHONE (Daytime Contact):�g,_ MAILING ADDRESS: N� 2 FUEL BURNING APPLIANCE > 100,000 X $19 (street) (city/state) (ZIP) CONTRACTOR: r—Jy� LICENSE #: MAILING ADDRESS: PHONE #: $100 5 USED APPLIANCE (WSEC min. AFUE rating) (street) (city/state) (ZIP) METHOD OF PAY DESCRIPTION OF WORK A OF UNITS X COST EQUALS AMOUNT 1 FUEL BURNING APPLIANCE • OR < 100,000 X $15 - N� 2 FUEL BURNING APPLIANCE > 100,000 X $19 3 UNLISTED APPLIANCE (ADDITIONAL FEE) - OR <400,000 X $50 4 UNLISTED APPLIANCE (ADDITIONAL FEE) > 400,000 X $100 5 USED APPLIANCE (WSEC min. AFUE rating) - or <400,000 X $50 6 USED APPLIANCE (WSEC min. AFUE rating) > 400,000 X $100 7 BOILER/REFRIGERATION 1-100M BTU X $IS - 8 BOILER/REFRIGERATION 101- 500M BTU X $28 9 1 BOILER/REFRIGERATION 501-1,000M BTU X $39 10 BOILER/REFRIGERATION 1001-1,750M BTU X $57 11 BOILER/REFRIGERATION +1750M BTU X $95 12 IGAS LOG, GAS INSERT, GAS FIREPLACE - X $10 - 13 RANGE - X $10 - 14 DRYER - X $10 - 15 FUEL BURNING WATER HEATER - X $10 - 16 MISC. FUEL BURNING APPL. - X $10 17 GAS PIPING (ea. Outlet) _ x $1 Ji 18 DUCE SYSTEMS _ X $10- 19 VENTILATING FANS - MAIX $10 20 AIR HANDLER (DOES NOT include ducting) - OR < 10,000CFM X $12 - 21 AIR HANDLER (DOES NOT include ducting) > 10,000 CFM X $19 22 EVAPORATIVE COOLERS - X $10 - 23 TYPE I HOOD _ X $50 24 TYPE II HOOD - X $10 - 25 HEAT PUMP/AIR CONDITIONER 0-3 TON X $12 - 26 AIR CONDITIONER 3-15 TON X $20 27 AIR CONDITIONER 15-30 TON X $25 - 28 AIR CONDITIONER 30-50 TON X $35 - 29 AIR CONDITIONER +50 TON X $60 - 30 LPG STORAGE TANK - X $10 - 31 WOOD OR PELLET STOVEIINSERT - X $10 - 32 WOOD STOVE - FREE STANDING - X $25 - yENT i SUBTOTAL: PLUS PROCESSING FEE: TOTAL PERMIT FEE DUE. $35.00 ❑ CASH ❑ CHECK DATE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: EXPIRES: ,1'6 r OF � OM%. �-alle 11707 E. SPRAGUE, S- TE 106 je SPOKANE VALLEY,, WA 99206 688-0036 FALX 509 688-0037 �509i r> .SITE INFORMATION Site Address: �; O��' N n • JGhnSc9n �1` Parcel Number: L4 tTV 57-Z- 2 Li 0 Subdivision: (/k f L5 Block:, Lot: 3 Zoning: .� • Water Dist: Owner: J�c t �v►^ 1,! �- ��S idC�'c� i Address: Building Inspector:r PROJECT TRANSMITTAL: TRANSMITTAL DATE: PERMIT INFORMATION Permit Number: Ooj-253Tssue Date: Permit Use:"�-R.� Applicant: Phone: Contact: ©c"- f f. 1 Phone: �� �_ ZZK� Contractor: Setbacks - Front:25--Left: Right: ' Rear: • APPROVALS BUILDINGS: PLANNING: ENGINEERS: SEWER FIRE WATER. DIS : STD ATER: APPROVALS 2"Z- 75 2-6 .st 1533 -Do CERTIFICATE OF SEWER AVAILABILITY This form is only to be submitted as an attachment to a fully completed application. Name of Sewer Utility: _,Q00eO VZ 01vtil / CERTIFICATION Project Name: o7�aS /t;/ Parcel Numbers: ySOS2. 24Y09 /moi" .9 94,e- / General Project Description: CW The above named Public Sewer System is capable of and will supply sewer service to the referenced project or subdivision. 1. Is sewer currently available, with service connections provided as required, to serve the proposed development (If yes, go to signature block; If no, go to 2a) ❑ Yes ❑ No 2a. Is the site within the Spokane County Sewer six-year Sewer Capital Improvement Program? (If no, go to 3) [:]Yes ❑ No 2b Will the developer design, fund, construct and provide financial surety for the necessary systems to provide Dryline Sewer and/or Double Plumbing Dry Side Sewers as required? (If no, go to 3) ❑ Yes ❑ No 3 Will the developer design, fund, construct and provide financial surety for the necessary systems to extend sewer service to the site and provide service connections as required? ❑ Yes ❑ No This Certificate of Sewer Availability is non -transferable to other projects and shall be valid as long as the referenced project remains active and is not modified. Certified by: Print Name Signature Title CONCURRENCY DETERMINATION Date If yes to question 1, or question 2b, or question 3 above, concurrency is satisfied for sewer. Otherwise, refer applicant to the Division of Utilities. ❑ This development is exempt from concurrency for sewer service. ❑ This development (does/does not) meet the concurrency requirements for sewer service. circle one Spokane County Representative Date CITU OF SPOKANE VALLEY Cert of Sewer Availability. doc 01/09/02 t