2007, 04-25 Permit App: 07001386 Residence-
Project Number: 07001386 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Project Information:
Date: 4/25/2007 Page 1 of 4
Permit Use: SFR W/ ATT GAR
Setbacks: Front 33 Left: 5 Right: 5 Rear: 16
Site Information:
Plat Key:
Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Phone: (509) 924-8964
Group Name:
. Project Name:
Name: Range
District: East
Parcel Number: 55191.0602 Block:
SiteAddress: 425 S MCKEE SP
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 Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information: ,
Review
Building Plan Review
Released By: - -
Driveway/Approach
Originally Released: 4/24/2007 By: TMELBOU
Released By: --_
Originally Released: 4/23/2007 By: jdavis
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Originally Released: 4/20/2007 By: kkendall
Released -By: -
Operator: JD
Printed By: JD
Print Date: 4/25/2007
Project Number: 07007386 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
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Item Description
APPROACH -CONST IN ROW
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Building Characteristics
Building Height 26
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
Description Qj Type Notes
1&2 FAMILY R-3 VB
COV DECK R-3 VB
DECK OPEN R-3 VB
GARAGE U-1 VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
This Application: Total Project:
Sq Ft Valuation Sq Ft Valuation
1,344 $122,787.84 1,344 $122,787.84
37 $555.00 37 $555.00
100 $1,500.00 100 $1,500.00
493 $9,367.00 493 $9,367.00
Totals: 1,974 $134,209.84 1,974 $134,209.84
Units Unit Desc
I SELECT
I SELECT.
1 SELECT
Operator: JD Printed By: JD
Permit Total Fees:
Print Date:
Fee Amount
$1,189.75
$4.50
$475.90
$1,670.15
4/25/2007
Project Number: 07001386 Inv: /
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 Fee Amount
1 NUMBER OF $10.00
1 NUMBER OF $10.00
1 NUMBER OF $12.00
2 # OF UNITS $2.00
3 NUMBER OF $30.00
1 NUMBER OF $10.00
I NUMBER OF $10.00
Permit Total Fees: $84.00
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 2 NUMBER OF $12.00
SINKS 3 NUMBER OF $18.00
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
Operator: JD Printed By: JD
Permit Total Fees: $66.00
Print Date: 4/25/2007
Project Number: 07001386 Inv: 1
Notes:
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/25/2007 Page 4 of 4
See plat file for TURTLE CREEK SOUTH 2ND for special drainage requirements
Payment Summary: -
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,670.15 $1,670.15 $0.00 $1,670.15
Mechanical Permit $84.00 $84.00 $0.00 $84.00
Plumbing Permit $66.00 $66.00 $0.00 $66.00
$1,870.15 $1,870.15 $0.00 $1,870.15
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: 07001386 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 1 of 3
Project Information:
Permit Use: SFR W/ ATT GAR Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Setbacks: Front 33 Left: 5 Right: 5 Rear: 16 Phone: (509) 924-8964
Group Name:
Site Information: Project Name:
Plat Key: Name: Range
District: East
Parcel Number: 55191.0602 Block:
Lot:
SiteAddress: 425 S MCKEE SP Owner: Name: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN RD
SPOKANE VALLEY, WA 99216
Location:: CSV
Zoning: UR -3.5 Urban Residential 3.5
Water District: 134 CONSOLIDATED ID #19 Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Lt formatiwr •
Review
Building Plan Review
Released By:
Driveway/Approach
Released By:
Landuse/Zoning/HE Conditions
Released By:
Sewer Review
Permits:
Operator: JD Printed By: JD
Print Date: 4/20/2007
aProject Number: 07001386
Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 4/20/2007 Page 1 of 3
Project Information:
Permit Use: SFR W/ ATT GAR
Setbacks: Front 33 Left: 5 Right: 5 Rear: 16
Site Information:
Plat Key:
Contact: DIAMOND ROCK CONSTRUCTION
Address: 2602 N SULLIVAN RD
C - S - Z: SPOKANE VALLEY, WA 99216
Phone: (509) 924-8964
Group Name:
Project Name:
Name: Range
District: East
Parcel Number: 55191.0602 Block:
SiteAddress: 425 S MCKEE SP
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 Hold: ❑
Area: 0 Sq Ft Width: 0 Depth: 0 Right Of Way (ft): 0
Nbr of Bldgs: 0 Nbr of Dwellings: 0
Review Information:
Review
Building Plan Review
as M
`RleB
y,,:
Driveway/Approach
Rel'eed By
Landuse/Zoning/HE Conditions
C:34-- re_ cur c --i0 1?1a (.) .
',Released I3
_ Y�,
Sewer Review
Permits -
Operator: JD Printed By: JD Print Date: 4/20/2007
Project Number: 07001386 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 3
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Item Description
APPROACH -CONST IN ROW
Contractor: DIAMOND ROCK
Address: 2602 N SULLIVAN
SPOKANE VALLEY WA 99216
Building Characteristics
Building Height 26
Description Grp
1&2 FAMILY R-3
F]CK e PEN Ca V R-3
GARAGE U-1
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
Type
VB
VB
VB
Item Description
RESIDENTIAL PERMIT FEE
WSBC SURCHARGE
SF PLNS RVW < 7999 SQ FT
Notes
This Application:
Sq Ft Valuation
3'•44 1744-3 $131,832.48
ietmec$1,500_00
`-41 3 442- $8,968.00
Total Project:
Sq Ft Valuation
134'1+443. $131,832.48
100 $1,500.00
472 $8,968.00
Totals: 2,015 $142,300.48
Contractor: DIAMOND ROCK
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
Units
1
1
1
Unit Desc
SELECT
SELECT
SELECT
Permit Total Fees:
Mechanical Permit
2,015 $142,300.48
Fee Amount
$1,234.55
$4.50
$493.82
$1,732.87
Firm: DIAMOND ROCK CONSTRUCTIO
Phone: (509) 924-8964
Units Unit Desc
1 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 # OF UNITS
3 NUMBER OF
1 NUMBER OF
1 NUMBER OF
Operator: JD Printed By: JD
Permit Total Fees:
Print Date:
Fee Amount
$10.00
$10.00
$12.00
$2.00
$30.00
$10.00
$10.00
$84.00
4/20/2007
Project Number: 07001386 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 3
Plumbing Permit
Contractor: DIAMOND ROCK Firm: DIAMOND ROCK CONSTRUCTIO
Address: 2602 N SULLIVAN Phone: (509) 924-8964
SPOKANE VALLEY WA 99216
Item Description
TOILETS/BIDETS
SINKS
TUBS
DISH WASHERS
CLOTHES WASHER
MISCELLANEOUS FIXTURES
Notes:
Units Unit Desc
2 NUMBER OF
3 NUMBER OF
2 NUMBER OF
1 NUMBER OF
1 NUMBER OF
2 NUMBER OF
Permit Total Fees:
Fee Amount
$12.00
$18.00
$12.00
$6.00
$6.00
$12.00
$66.00
See plat file for TURTLE CREEK SOUTH 2ND for special drainage requirements
Payment Summary: t, '1216C,Rfkillitlitrir% . J:711:r''5i r%.:;.f".: •.:•.,,,,;-21Z'r�Xk -..M .-MOri,4Ja °, Zfar.i.'71-3.).G1.:: -rnagarliit. E5 3E4^ itk.'.;=
Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing
Approach $50.00 $50.00 $0.00 $50.00
Building Permit $1,732.87 $1,732.87 $0.00 $1,732.87
Mechanical Permit $84.00 $84.00 $0.00 $84.00
Plumbing Permit $66.00 $66.00 $0.00 $66.00
$1,932.87 $1,932.87 $0.00 $1,932.87
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
Walley
Community Development
Permit Center c\*C,
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (502)W-0037\#\
tvw\v.spokanevallev.or/g. m ,(\ OO
Residential Construction
Permit Application
^'; PERM ITi]VUMB ER.'
')PERMITTEE., -
Construction
PERMIT FEE:,_,
Construction ❑ Accessory Bldg
Addition/Remodel o Deck
Other:
SITE ADDRESS H Z S 5. /44 C 51 -
ASSESSORS
fi
ASSESSORS PARCEL NO: / LEGAL DESCRIPTION: Lo F C Rl e. /
gig ildinggowner
Name: Drantend 40c Conr
Address: Z&o z. d/ rim Ivc /I 2d
-
Phone: 9'z LI _ Ina 9 Fax: 9LC-S'o951
Lic No: Exp. Date:
�. `.r;
Name:
Etta mo Ac /
.CG,t
C.0/1
57c.
Address:
# OF BEDROOMS:.3
nicri Ainngo
CONSTRUCTION TYPE:
NW SFR-
HEAT SOURCE:
AJectvrocI Aot-S Frrnuce.
SEWER OR SEPTIC?
Set te-
City:
Zip:
Phone:
Fax:
Contact=Persons
Name: PA U 1
Phone: Z-C-/92II
Describe the scope of work in detail:
gu;1d a. Att.) SFC
g elle i/Ile e5 JG fes
,iC. ac ort,~, -:»'•,?-? ' �"3 !+`v. '.t v` '4 e Lt a�'ta'� -.. ', _
Name: Drantend 40c Conr
Address: Z&o z. d/ rim Ivc /I 2d
City: See Kan c VIK Zip: 47 z/4
Phone: 9'z LI _ Ina 9 Fax: 9LC-S'o951
Lic No: Exp. Date:
City Business Lic No:
Cost of Project:
$ 5,00v
**************The followin2)\ZUST be complete: (write N/A if not a licabin' **************
HEIGHT TO PEAK: ,
2.6
DIMENSIONS:�O X
PP
# OF STORIES: ,
TOTAL HABITABLE SPACE:
!L/4/3
MAIN FLOOR TO SQ.
FTG:
Itl`l3
2Nu FLOOR SQ. FTG:
��
UNFIN BASEMENT SQ. FTG:
IMPERVIOUS SURFACE
AREA:
FINISHED BASEMENT
SQ. FTG: —��
GARAGE SQ. FTG:
L -i 7/. S
DECK/COV. PATIO SQ. FTG:
/00
30% SLOPES ON
PROPERTY:
# OF BEDROOMS:.3
nicri Ainngo
CONSTRUCTION TYPE:
NW SFR-
HEAT SOURCE:
AJectvrocI Aot-S Frrnuce.
SEWER OR SEPTIC?
Set te-
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 ¶t (Aat„gr
Date
Method of Payment: (Faxed permit applications will only be accepted with major bankcard)
❑ Cash ❑ Check ❑ Mastercard ❑ VISA
Bankcard #: Expires: VIN#:
Authorized Signature:
REVISED 8/25/2005
❑ Other
Spolcane�'
Val ley
Pernnl Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX. (509)688-0037
Community Development www,spokanet alio), we cow
Mechanical Permit Application o Commercial R( Residential
• .PERMFT=NUMBLR =i
'.° PERMIT: F1iS "'•:
SITE ADDRESS 14 2- s. (%11C Kee S4-
- ii u Hail, g
4
"Budding owner_'. f-::-.-....-.z:i;::..,..._;_:-..S _..iJ-, ". �-:`.r.:iii:4i>:._ .. , .... ,�. � ... -
a.
Name Q rel ✓LVaIAA Cart C:3115.17
Phone q 2.9- q y 6 2{
Fax q- c-2rpri se -
Address: 2 (p0 Z N. S c.7 ((llrec.n
City Sw KG,.se
Stale l✓fl- Zip qq Z/Ce
� .'t': �..'::n. ak1Y `i.':" _ `.;7 r'Ir''t:
�Cun[rae[or._��:.°,.,.-..��,.-f.`,:�...F���_7_-"=.3F;,;.. .:.-.-_�:.,-�;
"_ ic.. 4:d i�'i .'%��P. ._J
'' ..':.�4.,z.....::-'Ci?:r.�__
Y1131?" -7
ha. �
-�3:Y^, _.._ _�_,_
:a -
Name: CO✓%t 4,.r -D (2✓1*A /
Phone
Fax:
Address
City .
State
Zip
License No
City Business License No.
tContact_aL =aa`�".--3�.: -.�. fir,: ��'" -
k-" =-'-�'-:�-1-�+4.as'.
'm'aFaygsc�-=. x.
rte U`+l�a':s�s.,ai.P�`"-_?`r��,
��, �
Name' PG-tt (
Phone: 21'f— clic/ 24-/
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
FUEL BURNING APPLIANCE
Equal to or less than 100,000
X
$12 00
(Z
2
FUEL BURNING APPLIANCE
More than 100,000
X
$15 00
3
UNLISTED APPLIANCE (Additional 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
B OI LE R/R E F R I G E RATI ON
1 - 100M BTU
X
$12.00
8
BOILER/REFRIGERATION
101 - 500M BTU
X
$20 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
$60.00
12
GAS LOG, GAS INSERT, GAS FIREPLACE
X
$10 00
13
RANGE
X
$10.00
14
DRYER
X
$10 00
'O
15
FUEL BURNING WATER HEATER
x
$10.00
(6
16
MISC FUEL BURNING APPLIANCE
X
$10 00
17
GAS PIPING (each outlet)
X
$1.00
'Z
18
DUCT SYSTEMS
(
X
$10.00
(D
19
VENTILATING FANS
3
X
$10.00
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
$15.00
22
EVAPORATIVE COOLERS
X
$10 00
23
TYPE I HOOD
X
$50.00
24
TYPE II HOOD
X
$10.00
(0
25
HEAT PUMP/AIR CONDITIONER
• 0-3 TON
X
$12 00
26
AIR CONDITIONER
3-15 TON
X
$20 00
27
AIR CONDITIONER
15-30 TON
X
$25 00
28
29
30
31
32
33
34
35
36
37
AIR CONDITIONER
AIR CONDITIONER
LPG STORAGE TANK
30-50 TON
X
$35.00
More than 50 TON
WOOD OR PELLET STOVE/INSERT
WOOD STOVE - FREE STANDING
REPAIR 8. ADDITIONS
VENTILATION SYSTEMS
VENTILATION MECHANICAL EXHAUST
INCINERATOR - RESIDENCE
INCINERATOR - COMMERCIAL
METHOD OF PAYMENT:
DCASH ❑ CHECK 0 VISA 0 MC
CARD 4.
A UTTHORIZED SIGNATURE:
DATE
EXPIRES
X
X
X
x
X
X
X
SUBTOTAL
$60 00
$10.00
$10 00
$25.00
$15.00
$12.00
$12.00
$19.00
$22.00
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
REVISED 8/26/05
Permit Center
Spokane 11707E Sprague Ave, Suitc
cgs:soValley Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
Community Development wow sookancvallev 016 coni
Plumbing Permit Application
106
;'INERMIT NUMBER '
PERMIT FEE:.
❑ Commercial Ai Residential
SITE ADDRESS H LS s. /Mc kze Sf-
_-Building ow'ner4 __.."dk=>.. .- ;-�.. -,. -_ _- a ,a; _ _ +;Iti,. -
U;:l
Name. Bcanto A 12_0c it_ CarS I/ Phone: aZ/-/-x'9[(5/
Fax qz4 -so 9q
City 4tc✓t2
2 S vS�o
Address: (002 N. 111 Va/td1,,
State L✓/- Zip e9 7-/ co
..-
.. •;, tV.;:: ;4 _.fi'''
=Gontractor;?..;•1n _ -T .;`" s - /S`i - a u .-. ,,. i -`.'It �'.-
I ...�. .-- r-''e,(PG - 1 'C .?t '6/.0
ca': -...ac
/.
Name: �,r K-€- + Son S Pio *lb Ertl Phone
Fax:
Address: J City
State Zip
License No: City Business License No:
>..vy..`a,,:
8c"r"3-ma5kk %-;-.iContact: .F„9t •-,,,,ttn, ..
r `5,...' .a•x'a.,_•; .S. 4T ,r,F-,•.=:;.,-, ,i+q:-y �.'a,-., teg, - /.. r_ �.._�.�__vv".`�
": £4:,6/x„'•
., ,p .r
...*r_. ...:°:?: v.r.a+'.t.r-.
Name: (%1•rt i Phone' 2( 5( - If/ Z 4/
__
AUTHORIZED SIGNATURE.
REVISED 8/26/05
DESCRIPTION OF WORK
-
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
X
$6 00
-
-
/ 2.
2
URINALS
X
$6.00
3
TUBS
2-
X
$600
=
/2
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
3
X
$6 00
/
6
DISHWASHER
1
X
$600
=
63
7
CLOTHES WASHER
1
X
$6 00
=
/0
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
$600
=
13
FOUNTAINS, DRINKING
X
$6 00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6 00
=
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
._
X
$6.00
=
I L
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
$1500
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK
DATE.
SUBTOTAL
6c,
❑ VISA 0 MASTERCARD
PROCESSING FEE
$35.00
EXPIRES
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE.
REVISED 8/26/05
PLANNING ' EPT. APPROVED
BY.
DATE: 4 -"gael
I01.7t'
16,71_