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2008, 07-24 Permit App: 08002870 Cross Connect Device
ci �� (Staff Us Only) nePERMIT NUMBER: ,� PERMIT FEE: CITY OF SPOKANE VALLEY Community Development Department Permit Center 11703 East Sprague Avenue, Suite B-3 Spokane Valley, WA 99206 Tel: (509) 688-0036 Fax: (509) 688-0037 permitcenter©spokanevallev.orq PLUMBING PERMIT APPLICATION 0 COMMERCIAL ` ® RESIDENTIAL SITE ADDRESS:14311 E.WABAS SPOKANE VALLEY,WA 99216 BUILDING OWNER NAME:ADAM AND KRYSTAL TAYLOR NAME:ADAM AND KRYSTAL TAYLOR ADDRESS:14311 E WABASH CITY:SPOKANE VALLEY STATE:WA ZIP:99216 PHONE:(509)944-3922 FAX: CELL: CONTACT NAME: PHONE:(509)290-6134 FAX: CELL: CONTRACTOR NAME:NORTHWEST IRRIGATION AND LANSCAPING CO. MAILING ADDRESS:PO BOX 18243 CI ry:SPOKANE STATE:WA ZIP:99228 PHONE:(509)290-6134 FAX: CELL: CONTRACTOR LICENSE No.:NWIRRIL926MC EXPIRES:07/3/2010 CITY BUSINESS LICENSE NO.: Effective October 28, 2007 Page 1 of 2 http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Plumbing Permit App.1.doc • • 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 = LAVS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT 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 WATER HEATER NOTE: IF GAS,SEE MECHANICAL X $6.00 = AREA,CASE,COIL,TRENCH, 11 FLOOR DRAINS CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 = 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = ICE AN/OR COFFEE MAKER,HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, AND R.P.B.P.D.FOR: VATS,TANKS, 17 CROSS CONNECTION DEVICE BOILERS 1 X $6.00 = 6.00 GREASE TRAP,SAND TRAP, 18 INTERCEPTORS 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 $15.00 = SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: 41.00 DISCLAIMER The permitted verifies,acknowledges and agrees by their signature that: 1)if this permit is for construction 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) The 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 Date: Method of payment JO"Cash 0 Check 0 Visa 0 Mastercard Bankcard #: EXP: VIN#: i Authorized Signature: ,)1 ( t ill Effective October 28, 2007 Page 2 of 2 http://www.spokanevaliey.org/uploads/Community_Development/Documents/Forms/Building/Plumbing Permit App.1.doc Look Up a Contractor, Electrician, Plumber or Elevator Professional License Detail Page 1 of 2 • Information in Spanish I Topic Index I Contact Info I _. I Search;;l Home Safety Claims&Insurance Workplace Rights Trades&Licensing Find a Law(RCW)or Rule(WAC) Get a form or publication 0 Help Close this Page > General/Specialty Contractor A business registered as a construction contractor with L&tl to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must maintain a surety bond or assignment of account and carry general liability insurance. NW IRRIGATION Et LANDSCAPING CO Business and Licensing Information Verify Printer friendly Workers' Comp Premium Status Name NW IRRIGATION a UBI No. 602843625 LANDSCAPING CO Phone No. (509) 475-3123 Status ACTIVE Address PO BOX 18243 License No. NWIRRIL926MC Suite/Apt. License CONSTRUCTION Type CONTRACTOR City SPOKANE Effective 7/3/2008 Date State WA Expiration 7/3/2010 Date Zip 99228 Suspend Date County SPOKANE SepDateration e Business Previous INDIVIDUAL Type License Parent Next Company License Associated License Specialty 1 !' GENERAL Specialty 2 UNUSED a Business Owner Information L2. Hide All Name Role Effective Date Expiration Date MCINERNEY, SUSAN MARIE OWNER 07/03/2008 - Bond Information ij https://fortress.wa.gov/lni/bbip/Detail.aspx?License=NWIRRIL926MC 7/24/2008 Look Up a Contractor, Electrician,Plumber or Elevator Professional License Detail Page 2 of 2 • Bond Bond Effective Expiration Cancel Impaired Bond Received Bond Company Account Date Date Date Date Amount Date Name Number AMERICAN Until 2 STATES 6589201 07/14/2008 Cancelled $12,000.0007/14/2008 INS CO AMERICAN 1 STATES 6586835 07/03/200807/14/2008 $6,000.00 07/03/2008 INS CO B Insurance Information 4, Insurance Insurance Company Policy Effective Expiration Cancel Impaired Amount Received Name Number Date Date Date Date Date AMERICAN 1 STATES 01C10063771007/03/200807/03/2009 $500,000.0007/03/2008 INS CO {ess About L&I { Find a job at L&1 I Site Feedback { 1-800-547-8367 Ac alikWashington. 0 Washington State Dept.of Labor and Industries.Use of this site is subject to the laws of the state of Washington. Access Agreement I Privacy and security statement E Intended use/external content policy I Staff only link i10f@�zi,=aaa,;Hi,3ii✓�,; Wah'xuk'�"Mrm 7Ye.�:• cm;.v.;"Fvqc,'Js6n�:;.^.,,iaw.i.i+�a .,y na,�ai' �x.,a'+�1 Vruo-,.u�,ka;"+sxs..SaYornmwmau,. k917 gun-s';.P,"rt,a 5 r."m,,�'„"m;fi.4n-;t'Mwre as ,.>+4. 'tY�iS,Nnu�"c�.,Cx&=M�v "..::'edr,.Si • https://fortress.wa.gov/lni/bbip/Detail.aspx?License=NWIRRIL926MC 7/24/2008