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2008, 09-26 Permit App: 08003829 Mechanical/Plumbing FixturesProject Number: 08003829 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 9/26/2008 Page 1 of 2 Project Information: AWRISSIM Permit Use: 1 BOILER/FRID. 1 GS PP, 1 CROSS CONNECTION DEVICE Setbacks: Front Site Information: Left: Right: Rear: Contact: STANDARD PLUMBING & HEATING Address: 10415 E TRENT AVE C - S - Z: SPOKANE WA 99206 Phone: (509) 922-1717 Group Name: Project Name: Plat Key: 001865 Name: ORCHARD AVE ADD TR 1-228 District: Nort Parcel Number: 45063.3108 Block: SiteAddress: 8019 E LIBERTY AVE Location:: CSV Zoning: R-2 Lot: Owner: Name: SOUTH HILL BAPTIST CHURCH Address: 402 S COLEMAN RD SPOKANE, WA 99212-0540 SF Res Suburban District Water District: 002 ORCHARD AVENUE Area: 26,011 Sq Ft Width: 81 Nbr of Bldgs: 2 Nbr of Dwellings: 1 Hold: ❑ Depth: 167 Right Of Way (ft): 40 Review Information: Review Plan Review Permits: Released°: Contractor: STANDARD PLG HTG Address: 10419 E TRENT AVE SPOKANE, WA 99206 Item Description GAS PIPING BOILER/REFER 101-500M BTU PROCESSING FEE Mechanical Permit Firm: STANDARD PLG HTG CONTROL Phone: (509) 922-1717 Units Unit Desc 1 # OF UNITS 1 NUMBER OF 1 SELECT Operator: jmm Printed By: jmm Permit Total Fees: Print Date: Fee Amount $1.00 $20.00 $35.00 $56.00 9/26/2008 Project Number: 08003829 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 9/26/2008 Page 2 of 2 Plumbing Permit Contractor: STANDARD PLG HTG Firm: STANDARD PLG HTG CONTROL Address: 10419 E TRENT AVE Phone: (509) 922-1717 SPOKANE, WA 99206 Item Description CROSS CONNECTION DEVICES Units Unit Desc 1 NUMBER OF Permit Total Fees: Fee Amount $6.00 $6.00 Notes STOP WORK ORDER PLACED AT 8019 E LIBERTY AVE ON 10/22/97 NO PERMIT FOR REROOF RAVEN ROOFING TIME: 11:22 GAK/TAB INVESTIGATION FEE REQUIRED (NEW JERUSALEM CHURCH) Payment Summary: Permit Type Mechanical Permit Plumbing Permit Fee Amount Invoice Amount $56.00 $56.00 $6.00 $6.00 Amount Paid $0.00 $0.00 Amount Owing $56.00 $6.00 $62.00 $62.00 $0.00 $62.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: jmm Printed By: jmm Print Date: 9/26/2008 RECEIVED 09126/2008 10:30 5096880037 5V FENMil UtNItKrK Sep 26 2008 10:28AM SPHC - Standard Plumbing 509-927-4448 p.3 .0.0Valley CITY OF SPOKANE VALLEY Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 germ itcentertbspokan eval ley.orq N COMMERCIAL PERMIT NUMBER: PERMIT Fre: (Staff Use Only) PLUMBING PERMIT APPLICATION RESIDENTIAL SITE ADDRESS:8019 E LIBERTY, SPOKANE VALLEY, WA. 99212 BUILDING OWNER NAME: INDEPENDENT BAPTIST CHURCH NAME:INDEPENDENT BAPTIST CHURCH ADDRESS:SAME AS ABOVE CITv: STATe: ZIP: PHON e: (509)892-1123 FAx:(509)892-5411 caLL: CONTACT NAME:MAY PHONE: FAX caw CONTRACTOR NAME:STANDARD PLUMBING HEATING CONTROLS MAILING ADDRESS:10419 E TRENT CITY:SPOKANE VALLEY STATE:WA ZIP:99206 PHONE:(509)922-1717 FAx:(509)927-4448 CELL: CONTRACTOR LICENSE No.:STANDPH2340A EXPIRES: CITY BUSINESS LICENSE No.: N a5 -7=N\ lcO *`ZI 1,1;6 Effective October 28, 2007 Page 1 of 2 C:\Documents and Settings \Dons\ Desktop\Spokane Valley Permit Forms\Plumbing Permit App.1.doc RECEIVED 09/26/2008 10:30 5096880037 5V HtkMll (J.NItkrK Sep 26 2008 10:28AM SPHC - Standard Plumbing 509-927-4448 p.4 DISC AIMER The permkted verifies, acknowledges and agrees by their signature that: 1) If this permit Is for construction or on a dwelling, the dwelling Is wl ll be served by potable water. 2) Ownership of this City of Spokane Valley permit Inure to the property owner. 3) The signatory Is the property owner or has permission to represent the property owner in this transaction. 4) All construction Is to be done in full compliance with the City of Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley PermR Center. 5) The City of Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional Information may be required to be submitted and subsequently approved before thls application can be processed. Signature Date:9128/08 Method of payment: 0 Cash 0 Check Bankcarc Authorized Si • nature: ❑ Visa ® Mastercard This document originally contained card information which was redacted pursuant to RCW 19.255.010 and the original document destroyed pursuant to 505 DAN G52014-030. Effective October 28, 2007 Page 2 of 2 C:\Documents and Settings\Dons\Desktop\Spokane Valley Permit Forms\Plumbing Permit App.l.doc DESCRIPTION OF WORK ' # OF UNITS X COST • TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X 58.00 = 2 URINALS X 50.00 = 3 TUBS X 58.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ONSITE BUILT X $8.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR. KITCHEN, LAUNDRY. UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X 50.00 x 8 DISHWASHER X 58.00 = 7 CLOTHES WASHER X 58.00 L _ 8 GARBAGE DISPOSAL X $8 00 = 0 WATER SOFTENER X 58 00 = 10 ELECTRIC WATER HEATER NOTE: IF GAS, SEE MECHANICAL X $8 00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 58.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X 58 OD = 13 FOUNTAINS, DRINKING X 58.00 ■ 14 WATER MING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS X 56.00 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 86.00 18 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X 86.00 _ 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS 1 X 56.00 6.00 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 58.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X 58.00 =- 20 20 MISCELLANEOUS PLUMBING FIXTURE X 30.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X515.00 = SUBTOTAL 6.00 PROCESSING FEE 536.00 TOTAL PERMIT FEE DUE: 41.00 DISC AIMER The permkted verifies, acknowledges and agrees by their signature that: 1) If this permit Is for construction or on a dwelling, the dwelling Is wl ll be served by potable water. 2) Ownership of this City of Spokane Valley permit Inure to the property owner. 3) The signatory Is the property owner or has permission to represent the property owner in this transaction. 4) All construction Is to be done in full compliance with the City of Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley PermR Center. 5) The City of Spokane Valley permit Is not a permit or approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional Information may be required to be submitted and subsequently approved before thls application can be processed. Signature Date:9128/08 Method of payment: 0 Cash 0 Check Bankcarc Authorized Si • nature: ❑ Visa ® Mastercard This document originally contained card information which was redacted pursuant to RCW 19.255.010 and the original document destroyed pursuant to 505 DAN G52014-030. Effective October 28, 2007 Page 2 of 2 C:\Documents and Settings\Dons\Desktop\Spokane Valley Permit Forms\Plumbing Permit App.l.doc