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2003, 07-14 Permit App: BLD-03-02031 Water Piping crrt . , , po _.. ey • PLUMBING PERMIT APPLICATION PROJECT I PERMIT ADDRESS: 1 1 (No( 4 rJ�, USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: `_ (street) (city/state) (zip) CD LICrENSE#: € wc&d�1C..�-(N.Q &0 -1--: t)uRtctAr, 18 t k`1 MAILING ADDRESS: PHONE#: 507 ga1E1 Ss )c c t8' g, e G :P.r\ ,Res Via_ 99014 (street) (city/state) (zip) PLUMBING FIXTURES DESCRIPTION DETAILS S OF UNITS X COST• EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6 = . 2 URINALS X $6 3 TUBS X $6 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 = 5 SINKS LAVS/BASINS,BAR,FLOOR, X $6 KITCHEN,LAUNDRY,UTILITY, JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT = 6 DISHWASHER X $6 = 7 CLOTHES WASHER X $6 = 8 GARBAGE DISPOSAL : X $6 = 9 WATER SOFTENER X $6 = 10 ELEC HOT WATER TANK NOTE:IF GAS SEE MECHANICAL X $6 = 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, $6 CONDENSATE X = 12 FOUNTAINS,DRINKING X $6 = 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION, X $6 WASTE,VENT, REPAIR,REVERSALS PLUMBING REVERSAL = 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, X $6 HOSE BIB,STEAMER,PROOFER, CARBONATOR,SWAMP COOLER 16 CROSS CONNECTION VACUUM BREAKER,CHECK X $6 DEVICE VALVE,AND R.P.B.P.D.FOR: VATS,SUMPS,TANKS,BOILERS = 17 SPRINKLER SYSTEM X $25 18 INTERCEPTORS GREASE TRAP,SAND TRAP, $6 CHEMICAL HOLDING TANK X = 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 = 20 MISC PLUMBING FIXTURE X $6 = - {{ SUBTOTAL 0 CASH 0 CHECK 0 0 ='-! PLUS PROCESSING FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT $35.00 OFA MAJOR CREDIT CARD FEE TOTAL PERMIT FEE • DUE DATE: EXPIRES: . BANKCARD NUMBER: AUTHORIZED SIGNATURE: City of PERMIT # PW SPOKANE VALLEY UTILITY RIGHT-OF-WAY APPLICATION AND PERMIT PUBLIC WORKS DEPARTMENT APPLICATION n Location of property involved (or address) 3 N /1. ) £ 06 Name of company D C.c u RCIrNa1 E e_Q IA SA-', Address of company 19 g ) $ c phone gay '51S Contractors name T) u a14-\p C CA R Z i e Contractors address I q g l% 6 . S phone Ca4 Contractors registration Number COLAIC-C.,-IC t gi � $ 1 Expiration date j ()-03 Right of Way: Pavement or sidewalk intrusive. Yes No Intrusive outside of pavement or sidewalks. Yes No Length of cut ft. Depth of cut ft. Width of cut ft. Direction of cut Contact person V\e 1 e Lu 2 c R c Lk .i t\Q C,©UlpQ I,n'Q_, Address of contact 19"31 gq E, rIRAC, Phone 92-1--S- 25 Please explain in detail the description of the activity proposed. Pb , I hereby authorize the City of Spokane Valley to charge the fee for this permit to my credit card: Visa Mastercharge Print name of holder Signature PERMIT: Special Conditions Restoration: Permanent Temporary Type of back fill to be used: gravel crushed CDF IS A COPY OF A BOND DEPOSITED WITH THE CITY OF SPOKANE VALLEY ? A COPY OF THE CITY/UTILITY LIABILITY INSURANCE POLICY MUST BE ON FILE AT THE CITY. PERMIT FEE $ INSPECTION FEE $ Approved Public Works Director Date CALL 24 HOURS BEFORE INSPECTION NEEDED Phone 509-688-0036 Fax 509-688-0037 R-0- W APP.