2008, 06-27 Permit App:08002462 Water PipingSpokane.0.0
Valleyk
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
pe rm i tce n to r@spo ka n eva l I ey. o rg
PERMIT NUMBER:
PERMIT FEE:
RECEN .__.0 CY
(Staff Use Only)'���
yf�
CITY • + EY
JUN 2 7 2008
PE°r IT CENTER
RECEIVED
JUN 262008
EPgRTMENT OF
COM UN�i77ry DEVEL PMENT
PLUMBING PERMIT APPLICATION
❑ COMMERCIAL ® RESIDENTIAL
SITE ADDRESS:2723 WHIPPLE CT Vo ,51,66 ,51,66 1 Splca-ve_ kUl/9-
BUILDING OWNER NAME:CLIFFFORD W LYBBERT Pc cc I 14-.509I. 21-1-07
NAME:CLIFFORD W LYBBERT
ADDRESS:PO Box 676
CITY: MANCHESTER
PHONE:360 876-0171
CONTACT NAME:ENOCH LYBBERT
STATE:WA ZIP:98353
FAX:
CELL:360 649-7431
PHONE:509 235-8851
FAX: 7LL:509 991-2854
CONTRACTOR NAME:CLIFFORD W LYBBERT (OWNER)
;TAILING ADDRESS:SAME AS ABOVE
CITY:
STATE: ZIP:
PHONE:
FAX: CELL:
CONTRACTOR LICENSE No.:
EXPIRES: CITY BUSINESS LICENSE NO.:
E /-)c) c to-cy Vkly GyJti_ei (A) 't1( e -e_
7
UL -J)4011 Otk t Wp_
ecd( virt R.)LsQ-A- 4/4 5 rc-ccgry,
c i �- (A -p6 ' J �� 4160(i,(�'l'' -� tU se
aLt
0g1-va
Effective October 28, 2007 Page 1 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Plumbing Permit App.1.doc
vie
DISCLAIMER
The permitted verifies, acknowledges and agrees by thelr 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 thls 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 thls application can be processed. n d
Date: /co Tu.") WQcy p
Signature
Method of payment: 0 Cash ® Check
Bankcard #:
0 Visa 0 Mastercard
EXP:
VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Plumbing Permit App.l.doc
DESCRIPTION OF WORK
# OF UNITS
X
COST
•
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
56.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$8.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
58.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
=
..
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56.00
=
8.00
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
56.00
=
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
515.00
=
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
41.00
DISCLAIMER
The permitted verifies, acknowledges and agrees by thelr 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 thls 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 thls application can be processed. n d
Date: /co Tu.") WQcy p
Signature
Method of payment: 0 Cash ® Check
Bankcard #:
0 Visa 0 Mastercard
EXP:
VIN#:
Authorized Signature:
Effective October 28, 2007 Page 2 of 2
http://www.spokanevalley.org/uploads/Community_Development/Documents/Forms/Building/Plumbing Permit App.l.doc