2006, 04-18 Permit App: 06001372 Plumbing ReversalSpo"kane�`
.0,000Valley
Community Development
I- W11111
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (50976138-0037
www. spok an eval l e v. or e
Plumbing Permit Application
n Commercial
PERMIT NUMBER:
PERMIT FEE:
[Residential
SITE ADDRESS:
Building Owner
Name: .\,0 'j� iy\rn Phone: Fax:
Address: iii , I I Li C ✓lam City: 0 2,j",„ State: wit , t Zip: GR/ !
Contractor is
Name: 1
,, �jA'-/1 t- .e. 1p5( 0C�/` - i' ; • 57-0 : `5. 61—VG0
,
Address: 7,) _, 8 72--6tty: S State: (44 Zip: g c /. 3
License N.:34 /LL.---__ 4.j g&-(-4/ City B ness ic:
Contact
Name: Phone: 2 jg _Gy6, 7 —
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY. FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
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
=
7\
, 14 41
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
=
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
$15.00
=
METHOD OF PAYMENT:
❑CASH 0 CHECK 0 VISA 0 MC EXPIRES:
Card# VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8126/05
1
SPOKAII COu ti
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
1
Site Information
Project Information
Site Address: 14114 E MISSION AVE
Parcel Number: 45142.3105
Subdivision: VERADALE HEIGHTS, 13TH ADD TO
Block: 1 Lot: 5
Zoning: UNK Unknown
Owner: LOCHER, W R & M M
Address: 14114 E MISSION AVE
SPOKANE, WA 99216-1933
Building Inspector:
Water Dist:
Project Number: 06002062 Inv: 1 Issue Date: 4/12/2006
Permit Use: SEWER CONNECTION - VERADALE
Applicant: BAILEYS CONSTRUCTION
3707 E 28TH
SPOKANE, WA 99223
Contact: BAILEYS CONSTRUCTION
3707 E 28TH
SPOKANE, WA 99223
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Phone: (509) 532-0705
Phone: (509) 532-0705
Rear:
1 Permits
Sewer Connection Permit
Contractor: BAILEY'S CONSTRUCTION License #: BAILEC*088JW
SEWER CONNECTION
1 $85.00 PROCESSING FEE 1 $15.00
Total Permit Fee: $100.00
FOR SEWER INSPECTIONS CALL THE UTILITIES DEPT AT (509) 477-3604 FROM 8:30-5:00 MONDAY -FRIDAY PRIOR TO
COVER. ONE WORKING DAY NOTICE REQUIRED. PERMIT ALLOWS FOR A 30 -MINUTE INSPECTION. ADDITIONAL
INSPECTION FEES APPLY AFTER 30 MINUTES.
THE INSTALLER IS RESPONSIBLE TO INSURE ALL WASTEWATER DRAINS ARE CONNECTED TO THE SEWER AND
MAY BE REQUIRED TO PERFORM TESTS FOR VERIFICATION. INSTALLER IS TO FIELD LOCATE AND CONFIRM THE
ELEVATION AND POSITION OF SEWER STUB PRIOR TO ANY OTHER EXCAVATION.
SEWER STUBS ARE TO BE CHECKED PRIOR TO CONNECTION TO ENSURE THAT THEY HAVE ACCEPTABLE GRADE
AND ARE CLEAR AND UNOBSTRUCTED TO THE MAIN. SEWER LI NES SHOULD BE CONSTRUCTED TO ALLOW FOR
GRAVITY FLOW FROM THE LOWEST LEVEL OF THE STRUCTURE.
THE INSTALLER AND THIS PERMIT MUST BE PRESENT AT THE JOB SITE AT THE SCHEDULED INSPECTION TIME.
BOTH STATE LAW RCW 19.122 AND COUNTY CODE REQUIRES THE INSTALLER TO GIVE NOTICE OF EXCAVATION TO
OWNERS OF UNDERGROUND FACILITIES.
CALL 1-800-424-5555 BEFORE YOU DIG --AT LEAST 2 WORKING DAYS IN ADVANCE. SPOKANE COUNTY CODE
REQUIRES THE INSTALLER COMPLY WITH ALL REQUIREMENTS OF THE WA STATE DEPT OF LABOR & INDUSTRIES,
INCLUDING THOSE RELATED TO TRENCH SAFETY.
Payment Summary
Total Fees AmountPaid AmountOwing
$100.00 $100.00 $0.00
Tran Date Receipt # Payment Amt
4/12/2006 1692 $100.00
Processed By: SHATTO, JULIE
Printed By: WENDEL, GLORIA Page 1 of 1
PERMIT