2007, 04-25 Permit App: 07001387 ResidenceProject Number: , 07001387 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/25/2007 Page 1 of 4
Project Information:
Permit Use: SFR W/ATT GAR
Setbacks: Front 33 Left: 5 Right: 5 Rear: 33
Site Information:
Plat Key: Name: Range
Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Phone: (509) 924-8964
Group Name:
Project Name:
District: East
Parcel Number: 55191.0602 Block:
SiteAddress: 419 N MCKEE ST
Location:: CSV
Lot:
Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19
Area: 200,970 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Released By:
Driveway/Approach
Originally Released: 4/24/2007 By: TMELBOU
Released By:
Originally Released: 4/24/2007 By: j_davis
Landuse/Zoning/HE Conditions
Released By: . -- -
Sewer Review
Permits:
Originally Released: 4/23/2007 By: KKENDAL
Released By:
Operator: JD Printed By: JD
Print Date: 4/25/2007
Project Number: 07001387 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/25/2007 Page 2 of 4
Approach
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Item Description
APPROACH -CONST IN ROW
Units Unit Desc
1 NUMBER OF
Fee Amount
$50.00
Permit Total Fees: $50.00
Building Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Building Characteristics
Building Height 25
This Application: Total Project:
Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation
I&2 FAMILY R-3 VB 712 " $65,048.32 712 $65,048.32
2ND FLOOR R-3 VB 736 $54,964.48 736 $54,964.48
BASEMENT U R-3 VB 690 $10,350.00 690 $10,350.00
COV DECK R-3 VB 100 $1,500.00 100 $1,500.00
DECK OPEN R-3 VB 210 $3,150.00 210 $3,150.00
GARAGE U-1 VB 459 $8,721.00 459 $8,721.00
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW <7999 SQ FT
Totals: 2,907 $143,733.80 2,907 $143,733.80
Units Unit Desc
1 SELECT
I SELECT
1 SELECT
Operator: JD Printed By: JD
Fee Amount
$1,240.15
$4.50
$496.06
Permit Total Fees: $1,740.71
Print Date: 4/25/2007
Project Number: , 07001387 Inv: I
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/25/2007 Page 3 of 4
Mechanical Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Item Description
DUCT SYSTEMS,
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
HOOD -TYPE 11
Units Unit Desc
I NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 # OF UNITS
4 NUMBER OF
I NUMBER OF •
1 NUMBER OF
Fee Amount
$10.00
$10.00
$12.00
$2.00
$40.00
$10.00
$10.00
Permit Total Fees: $94.00
Plumbing Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 3 NUMBER OF $18.00
SINKS 4 NUMBER OF 524.00
TUBS 2 NUMBER OF 512.00
DISH WASHERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
MISCELLANEOUS FIXTURES 2 NUMBER OF $12.00
Operator: JD Printed By: JD
Permit Total Fees: $78.00
Print Date: 4/25/2007
Project Number: 07001387 Inv: /
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/25/2007 Page 4 of 4
Notes:
See plat file for TURTLE CREEK SOUTH 2ND for special drainage requirements
Payment Summary:
Permit Type Fee Amount Invoice Amount
Approach $50.00 $50.00
Building Permit $1,740.71 $1,740.71
Mechanical Permit $94.00 $94.00
Plumbing Permit $78.00 $78.00
$1,962.71 $1,962.71
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$1,740.71
$94.00
$78.00
$0.00 $1,962.71
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: JD Printed By: JD
Print Date: 4/25/2007
Project Number: 07001387 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/23/2007 Page 1 of 4
Project Information:
Permit Use: SFR W/ATT GAR
Setbacks: Front 33 Left: 5 Right: 5 , Rear: 33
Site Information:
Plat Key:
Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Ro
Phone: (509) 924-8964
Group Name:
Project Name:
Name: Range
District: East
Parcel Number: 55191.0602 Block:
SiteAddress: 419 N MCKEE ST
Location:: CSV
Lot:
Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19
Area: 200,970 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information •
Hold: ❑
Depth: 0 Right Of Way (ft): 0
Review
Building Plan Review
Released 13y:
Driveway/Approach
ReleasedBy:.
Landuse/Zoning/HE Conditions
Released 13y:
Sewer Review
Permits:
Released By:
Operator: JD Printed By: JD
Print Date: 4/23/2007
Project Number: 07001387 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information: _
Permit Use: SFR W/ATT GAR .�.d.a._..,�,,. Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Setbacks: Front 33 Left: 5 Right: 5 Rear: 33 Phone: (509) 924-8964
Group Name:
Site Information: Project Name:
Plat Key: Name: Range
Date: 4/20/2007 Page 1 of 4
District: East
Parcel Number: 55191.0602 Block:
SiteAddress: 419 N MCKEE ST
Location:: CSV
Lot:
Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
Zoning: UR -33 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID#19 Hold: ❑
Area: 200,970 Sq Ft Width: 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Depth: 0 Right Of Way (ft): 0
Review.
Building Plan Review
`Releagl;By:: e3:1 ".
Driveway/Approach
,`Released'
Landuse/Zoning/HE Conditions
EReIe'asediBy:p-.9n4:
Sewer Review
Permits •
•Released . N
.Y. ±ati
Operator: JD Printed By: JD Print Date: 4/20/2007
Project Number: 07001387 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 2 of 4
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Item Description
APPROACH -CONST IN ROW
Contractor
Address:
DIAMOND ROCK
2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Building Characteristics
Building Height 25
DescriptionGrp Type
1&2 FAMILY R-3 VB
2ND FLOOR R-3 VB
BASEMENT U R-3 VB
DECK OPEN R-3 VB
GARAGE U -I VB
tog Ptttb 0..3 %/IS
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW W < 7999 SQ FT
Operator: JD
Approach
Firm: DIAMOND ROCK CONSTRUCTIO
Phone: (509) 924-8964
Units Unit Desc
1 NUMBER OF
Permit Total Fees:
Building Permit
Fee Amount
$50.00
$50.00
Firm: DIAMOND ROCK CONSTRUCTIO
Phone: (509) 924-8964
Notes
This Application: Total Project:
Sci Ft Valuation Sq Ft Valuation
12- SIO $77,656.00 850 $77,656.00
136 486 536,294.48 486 536,294.48
fey O '850 $12,750.00 850 $12,750.00
2ie 490 $1,500.00 100 $1,500.00
9S9 460 $8,740.00 460 $8,740.00
Totals q 2,746 $136,940.48 2,746 $136,940.48
Units Unit Desc Fee Amount
1 SELECT $1,200.95
1 SELECT $4.50
1 SELECT $480.38
Printed By: JD
Permit Total Fees: $1,685.83
Print Date:
4/20/2007
Project Number: 07001387 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 3 of 4
Mechanical Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Item Description
DUCT SYSTEMS
GAS WATER HEATER
GAS APPLIANCE<=100,000BTU
GAS PIPING
VENTILATING FANS
CLOTHES DRYER
HOOD -TYPE II
Phone: (509) 924-8964
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 # OF UNITS
4 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Fee Amount
$10.00
$10.00
$12.00
$2.00
$40.00
$10.00
$10.00
Permit Total Fees: $94.00
Plumbing Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Item Description Units Unit Desc Fee Amount
TOILETS/BIDETS 3 NUMBER OF $18.00
SINKS 4 NUMBER OF $24.00
TUBS 2 NUMBER OF $12.00
DISH WASHERS 1 NUMBER OF $6.00
CLOTHES WASHER 1 NUMBER OF $6.00
MISCELLANEOUS FIXTURES 2 NUMBER OF $12.00
Permit Total Fees: $78.00
Operator: JD Printed By: JD Print Date: 4/20/2007
Project Number: 07001387 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 4 of 4
See plat file for TURTLE CREEK SOUTH 2ND for special drainage requirements
Payment Summary:
Permit Type
Approach
Building Permit
Mechanical Permit
Plumbing Permit
Fee Amount Invoice Amount
$50.00
$1,685.83
$94.00
$78.00
$50.00
$1,685.83
$94.00
$78.00
$1,907.83 $1,907.83
Amount Paid
$0.00
$0.00
$0.00
$0.00
Amount Owing
$50.00
$1,685.83
$94.00
$78.00
$0.00 $1,907.83
Disclaimer:
Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information
contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be
complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of
the provisions of the code or of any other state or local laws or ordinances.
Signature:
Operator: JD Printed By: JD Print Date: 4/20/2007
•1
Ar}ies -z >-fce
Permit Center
Sliokane �11707 E Sprague Ave, Suip C
P
6
xo'200 Valley Spokane Valley, wA-4906
(509)638-00361f$x. (509)688-003-
Community Development wnwsl a
invallev.ore.cert
^1t
Residential ConstrO tion P`% %, New Construction
Permit Application o Addition/Remodel
❑ Other:
rsi':PERk I yic 6.11
-:PERMITTEE!
o Accessory Bldg
o Deck
SITE ADDRESS 1-11q ti. ✓lc Ket Sl-,
ASSESSORS PARCEL NO: LEGAL DESCRIPTION
ditulding(ownecs
Name: 7., t.rme,nC)47ein( *' CoAS'1-.
Address: Z t, O Z Vn /l 2d.
City: SPo kcjA.Q Vtit Zip: 99tu
Phone: q Z N- (WY Fax: Of 16.- `6o ei r-/
Noris,.y:�..y-�: - t.r:.:yr�..
Contactf]'erson ,; °_i
Name: Qpm,\
Phone: Z t - gel 224
Describe the scope of work in detail:
gu:l 1 0 ;new S F E
Lod 5 BIR 2 ,&e Ile as7lle Is/ayes
;Cont`ractor ;
Name: Dia Nto) J Po( k (ovt S
Address:
City:
Zip:
Phone:
Fax:
Lic No: Exp. Date:
City Business Lic No:
Cost of Project:
1 $ 7o, 000
**************The following MUST • be corn
•
tete. ( ta
wn 11 11u1 appncante/^--nwwwwwww********
p N/A '
HEIGHT TO PEAK:.DIMENSIONS:
Z
35X41'0
# OF STORIES:
e-
TOTAL HABITABLE SPACE:
1331
MAIN FLOOR TO SQ.
FTG:
53 50
2NV FLOOR SQ. FTG:
,Jr
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG: ES
GARAGE SQ. FTG:
I" (00
DECK/COV. PATIO SQ. FTG:
/00
30% SLOPES ON
PROPERTY: N/Ii-
# OF BEDROOMS: 3
CONSTRUCTION TYPE:
SFa
HEAT SOURCE:
Nc,tvrai 6cLs Furnc.(R
SEWER OR SEPTIC?
SP.1..Ye-T
DISCLAIMER
The permitee verifies, acknowledges and agrees by their signature that: 1) If this permit is for construction of or on a dwelling, the
dwelling is/will 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 Permit Center. 5) This 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
this application can be processed.
Signature
a,uk C qcr
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
0 Cash
Bankcard #: ❑ Check ❑ Mastercard 0 VISA
Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
❑ Other
p Permit Center
SI)Ok e 11707 L Sprague Ave, Surae 106
Spokane Valley, WA 99206
(5091683-0036 FAX (509)685-0037
Valley
Community Development wwwspokanevalle'm corn
SP) RMI7=_NUMBER:'w
rePERMIT PEE
Mechanical Permit Application o Commercial r'Residential
SITE ADDRESS LI 19 N. tM L ICn. CP
- Building'owrier -:-. i Y- - V .v ,
Fax, e-, `.y .... -
M
Name: P.Ci GNL) Roc (0vt S'f. Phone: GZ
1 YJ 3'nti (✓ Cly
GZ J'
Address: Z4:0Z ,V- SJll,VA.A ! e
City Spo K -G ✓� 61j�Slale (,,,Jd4 zip t`7 Z��
__.._ _
f: -.,,f: ,t. :h`,4 a- - - - -4.r: - = __ •:=-1:>: �--ir v--...
-" "3 - � ._ _._y. ) - ..' S '..- .--,. y. - w- - n tli - -- ,S --"r,sis �`*'#_ - .?. `tNk.fU .'_.��"'•1:,
( L
Name: COM For'I- 6..A.t--rek 6..A.)--rI Phone. qe,f- /1 5(0 Fax: --.
Address: City State Zip
License No:
ty Business License Noses;.;
CContac[:
�f:a3 ,5iae,_;,..,'.1, •«:-
.I,a=,,,..;��-"_� -$ :..�2._r'r ;. ,-v�,,'?7:�Ev:..�..:'
- '9 id .ri ➢a�1 �4, fR'�:�,TK:..iiS`.n�>..§..::.Y3i'.d¢�t6^Y:�,t,Y. .i�'�'1.1
Name:
. .6•'•'k'3..m
Pa IA Phone. ?/9-99111
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
1
X
$12 00
=
1 2--
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15 00
3
UNLISTED APPLIANCE (Additiona! Fee)
Equal to or less than 400,000
X
$50 00
4
UNLISTED APPLIANCE (Additional Fee)
More than 400,000
X
$100 00
=
5
USED APPLIANCE (WSEC min. AFUE rating)
Equal to or less than 400.000
X
$50 00
=
6
USED APPLIANCE (WSEC min. AFUE rating)
More than 400,000
X
$100 00
=
7
BOILER/REFRIGERATION
1-100M BTU
X
$1200
=
8
BOILER/REFRIGERATION
101 - 500M BTU
X
520.00
9
BOILER/REFRIGERATION
501 - 1,000M BTU
X
$25.00
=
10
BOILER/REFRIGERATION
1,001 - 1,750M BTU
X
$35.00
=
11
BOILER/REFRIGERATION
More than 1.750M BTU
X
$6000
=
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
510.00
=
13
RANGE _
1
X
51000
=
14
DRYER
1
X
$1000
=
)0
15
FUEL BURNING WATER HEATER
1
X
$1000
=
10
16
MISC FUEL BURNING APPLIANCE
X
$10.00
=
17
GAS PIPING (each outlet)
Z
X
$1 00
=
(.
18
DUCT SYSTEMS
1
X
$1000
=
10
19
VENTILATING FANS
1-1
X
$1000
r
ii
20
AIR HANDLER (DOES NOT include ducting)
Equal to or less than 10,000 CFM
X
$12 00
21
AIR HANDLER (DOES NOT include ducting)
Greater than 10,000 CFM
X
515.00
22
EVAPORATIVE COOLERS
X
$1000
=
23
TYPE I HOOD
X
550 00
=
24
TYPE II HOOD
1
X
$1000
=
lo
25
HEAT PUMP/AIR CONDITIONER
0-3 TON
X
512.00
=
26
AIR CONDITIONER
3-15 TON
X
52000
=
27
AIR CONDITIONER
15-30 TON
X
$2500
28
AIR CONDITIONER
30-50 TON
X
53500
29
AIR CONDITIONER
More than 50 TON
X
560.00
30
LPG STORAGE TANK
X
$10 00
=
31
WOOD OR PELLET STOVE/INSERT
X
$10.00
32
WOOD STOVE - FREE STANDING
X
$25 00
33
REPAIR 8, ADDITIONS
X
515.00
=
34
VENTILATION SYSTEMS
X
512.00
=
35
VENTILATION MECHANICAL EXHAUST
X
$12.00
=
36
INCINERATOR -RESIDENCE
X
$19.00
=
37
INCINERATOR -COMMERCIAL
X
$22.00
=
METHOD OF PAYMENT:
DCASH 0 CHECK 0 VISA 0 MC
CARD #.
SUBTOTAL
Q tI
DATE
PROCESSING FEE
535.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 9/7(,105
Pei mt Centel
Spokane 11707 E Sprague Ave, Suite 106
1/211ey Spokane Valley, WA 99206
(509)(S8-0036 FAX' (509)688-0037 a,r.;,.n;:.r-.,-�"vH
Community Development www sookaitevallc y Tile; coni
Plumbing Permit Application o Commercial qg,Residential
SITE ADDRESS Ltd- / N. /I4C Ate_
Birildingon$'c
Name. Of et v1.4-0 d RDCK C S•f-
Address. Z(a OZ 4). SU IIIvcm c1
Phone: 9 it/ - $9 6
Fax
City
State
ryv%u:_ a
Zip
Name: 11n t %e 47 S o,S
Phone:
Address:
License No:
3Contact
City
City Business License No:
Fax:
State
Zip
Name. 'Pq,L\
Phone' 21F-4/92tf
METHOD OF PAYMENT:
❑ CASH
DATE:
❑ CHECK
AUTHORIZED SIGNATURE:
0 VISA 0 MASTERCARD
EXPIRES:
SUBTOTAL
70
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6.00
=
AMOUNT
18
2
URINALS
X
$6.00
=
3
TUBS
Z
X
$6.00
= 1 2-
4
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
LI
X
$6.00
Z N
6
DISHWASHER
I
X
$6 00
/
= rp
7
CLOTHES WASHER
1
X
$6 00
= (p
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
X
$600
=
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
Z
X
$e 00
=
) Z
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
56 00
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20 00
_
22
INDUSTRIAL WASTE
INTERCEPTOR
V
tic
METHOD OF PAYMENT:
❑ CASH
DATE:
❑ CHECK
AUTHORIZED SIGNATURE:
0 VISA 0 MASTERCARD
EXPIRES:
SUBTOTAL
70
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
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RECEIVED 3d ► e v;11 e Z -S 'teih s
APR 2 3 2007 y i9 s 41t. k:o4 s'fi
SPOKANt VALLEY
DEPAREF
COMMUNITYDEVEL � MENT
PLANNING DEPT. PPROVED
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BY.
DATE.
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