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2006, 06-26 Permit App: 06002483 Plumbing FixturesProject Number: 06002483 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 06/26/2006 Page 1 of 2 Project Information: Permit Use: (3) TOILET (1) TUB (3) SINK (1) DW (1) WASHER (1) DISP (1) DRAIN Setbacks: Front Left: Right: Rear: Contact: FREESTONE PLUMBING, INC Address: 5525 E DICKINSON LN C - S - Z: COLBERT, WA 99005 Phone: (509) 953-8221 Group Name: Site Information: Project Name: �,-,,,,. M a Ods . 4,`"FROMW, N .: -r .: s ... ter....., Plat Key: Name: ORCHARD PARK ADD District: Nort Parcel Number: 45063.4426 Block: SiteAddress: 3304 N PARK RD Location:: CSV Zoning: UR -3.5 Water District: Urban Residential 3.5 Area: 6,829 Sq Ft Width: 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: Permits: Contractor: FREESTONE PLUMBING INC Address: 5525 E DICKINSON LN COLBERT, WA 99005 Item Description TOILETSBIDETS SINKS TUBS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER FLOOR DRAINS MISCELLANEOUS FIXTURES PROCESSING FEE Units 1 3 1 1 1 1 1 3 1 Operator: MT Printed By: MT Lot: Owner: Name: Address: EVANS CONSTRUCTION & REM 17802 N LARRY LN COLBERT, WA 99005 Hold: ❑ Depth: 0 Right Of Way (ft): 0 Plumbing Permit Firm: FREESTONE PLUMBING INC Phone: (509) 238-6705 Unit Desc NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF NUMBER OF SELECT Fee Amount $6.00 $18.00 $6.00 $6.00 $6.00 $6.00 $6.00 $18.00 $35.00 Permit Total Fees: $107.00 Print Date: 06/26/2006 ' Project Number: 06002483 Notes: Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 06/26/2006 Page 2 of 2 Payment Summary Permit Type Plumbing Permit Fee Amount Invoice Amount $107.00 $107.00 $107.00 $107.00 r, g.°.tP'.liMM 4. : u`A , ... - .A+#',5,;.'x ..M&YuAMM A_ ; A A.':e-£' A Amount Paid $0.00 $0.00 Amount Owing $107.00 $107.00 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: MT Printed By: MT Print Date: 06/26/2006 Community Development Sfoggie 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.ore Plumbing Permit Application (1 Commercial PERMIT NUMBER: lam' ‘( PERMIT FEE: [l Residential SITE ADDRESS: 33.44 N . Building Owner Name: SCoTr E✓.4/V5 Co/V.57' Phone: IT" _ 483o Fax: Address: /7 Boz. N . L47 City: G'D L B E?L.T State: • Zip: 110 05 Contractor Name: F/26EST0.vE PLNA-fB/NCT/ /A/G • Phone: 953 '8Z2/ Fax: (5201 3 2 38 - /7aa. Address: 55 25 C. 17 /C_se/,rscud W. City: C0L43ER — State: wA Zip: eNo05 License No: FLEE SP= �G7d / City Business Lic: Contact _ .. Name. JA50,1 7YNl�LJ01M Phone: (5o9) 9s 3 —82Z 1 DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS / WATER CLOSET, BIDETS X $6.00 2 URINALS X 86.00 3 TUBS / 9 x $6.00 4 SHOWERS (PER TRAP) BATH, STALL, ONSITE BUILT X $6.00 5 SINKS /1/ LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 3 X 86.00 /8. av 6 DISHWASHER X 86.00 7 CLOTHES WASHER / / X $6.00 6 0,0 8 GARBAGE DISPOSAL / / X 86.00 9 WATER SOFTENER X 86.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 86.00 11 FLOOR DRAINS / AREA, CASE. COIL TRENCH, CONDENSATE / X $6.00 12 ROOF DRAINS/OVERFLOW DRAINS X 86.00 13 FOUNTAINS, DRINKING X $6.00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS X 86.00 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X 86.00 16 WATER USING DEVICE /1/ ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER 3 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 DISPOSAL/SYS X $20.00 22 INDUSTRIAL WASTE INTERCEPTOR X 815.00 METHOD OF PAYMENT: MASH ❑ CHECK li/ISA 0 MC Card# AUTHORIZED SIGNATURE: REVISED $ EXPIRES: VIN: SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: 835.00