2006, 05-19 Permit App: 06001906 Plumbing ReversalSpo"kane�"'
��1a-lley
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.ors
Plumbing Permit Application
PERMIT NUMBER p
PERMIT FEE:
❑ Commercial ❑ Residential
SITE ADDRESS: 413t*11 1 1.9 C- ug, I.vAri
Building Owner
Name:yvlrFR. c S'T7 F7�•�
Phone:
Fax:
Address: / 111 e VA- /kr,.14.7
City:
State:
Zip:
Contractor iy1l i' I./rYrl l�
Name:
Phone: 122_ / S i f
Fax:
Address: j pi E V4,,,f teri LAtut
City:
State:
Zip:
License No:
City Business Lic:
Contact ;:
Name:
Phone:
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
LAVS/BASINS, 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
14
WATER PIPING/DRRAIWIN WAS
VENT, PLUMBING,ZtEVERALL
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
86.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
86.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
,CASH CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATUREi
REVISED 5126105
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
835.00
TOTAL PERMIT FEE DUE:
541
SPOKAIN COtAstr'
SPOKANE COUNTY
DEPARTMENT OF BUILDING & PLANNING
1026 WEST BROADWAY AVENUE • SPOKANE, WA 99260-0050
Site Information
Site Address: 11919 E VALLEYWAY AVE
Parcel Number: 45164.0284
Subdivision: OPPORTUNITY TR # 01-354
Block: Lot:
Zoning: AGS
Owner: STIFTER, MARIE
Address: 11919 E VALLEYWAY AVE
SPOKANE, WA 99206
Building Inspector: None
Water Dist:
Project Information
Project Number: 06003190 Inv: 1 Issue Date: 5/17/2006
Permit Use: SEWER CONNECTION
Applicant: COURCHAINE CONSTRUCTION
19818 E SPRAGUE
GREENACRES, WA 99016 Phone: (509) 924-5485
Contact: COURCHAINE CONSTRUCTION
19818 E SPRAGUE
GREENACRES, WA 99016 Phone: (509) 924-5485
Setbacks - Front: Left: Right:
Group Name:
Project Name:
Rear:
Permits
Sewer Connection Permit
Contractor: COURCHAINE CONSTRUCTION License#: COURCC*181 R7
$85.00 PROCESSING FEE 1 $15.00
SEWER CONNECTION 1
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 LINES 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 Tran Date Receipt # Payment Amt
$100.00 $100.00 $0.00 5/17/2006 2551 $100.00
Processed By: CUMMINGS, KATHY PERMIT
Printed By: WENDEL, GLORIA Page 1 of 1