1994, 10-19 Permit App: 94010474 Sewer o� Dr SEWER CONNECTION PERMIT (it] . 1001
APPLICATION FORM
PLEASE NOTE: This application form must be filled out accurately and in its entirety, and signed,
or a permit will not be issued.
PROJECT INFORMATION
Job address: � � Ownerme:�
City: City/State:
Zip: /` Zip:
Parcel number (if known): Phone:
WILL THE PROPERTY OWNER BE PERFORMING THE SEWER CONNECTION
INSTALLATION?* Yes No
*If property owner is installing the sewer connection, they must first contact the UTILITIES DEPARTMENT for construction
requirements before the permit is issued.
CONTRACTOR INFORMATION
Contractor (company name): State contractor license number:
74.001.5-1Tp rt 3 ions-I'r a c-ri or, A-R.M.S1 cL - 1 ci 2 IJ 1
Business address: Utilities installers permit number:
Pa 6t)c 11-1-Z52
City/State: ,S p Cup VVA
Zip: C1 042-11-4- Phone: 92. s _ 05 S q
INTERIOR PLUMBING ALTERATIONS (if applicable)**
Contractor (if different from above): Phone:
Business Address: City/State/Zip:
** For plumbing reversal fee information, see reverse side of this form.
FEE INFORMATION
Sewer Connection: Number of Buildings J X (times) $50 (per bldg) _ $
TOTAL FEE
(One permit required for each separate building, shop,garage, etc., th t will be connected to the sewer)
APPLICANT SIGNATURE:r �% ./ 46 ir_ s ate: Q
Spokane County Division of Buildings
West 1026 Broadway Avenue * Spokane, Washington 99260 * (509) 456-3675
PLUMBING PERMIT APPLICATION
PROJECT ADDRESS:
OWNER: PHONE:
MAILING ADDRESS:
(street) (city/state) (zip)
CONTRACTOR: A c b 4f-.�- `A ah n �r) LICENSE:4D AEi J p 8 1
PHONE: 0
MAILING ADDRESS: I ri Sc9_ 'P/_f A r.cert.CA.c.rcc t.W/A q q 01
(street) (city/state) (zip)
PLUMBING FIXTURES # OF MULTI- COST
DESCRIPTION I DETAIL UNITS PLIED BY /UNIT EQUALS AMOUNT
$3.02 TOILETS WATER CLOSETS,BIDETS x $6 = $
003 URINALS - x $6 = $
1304 TUBS BATH,JACUZZI,SPA,GARDEN x $6 = $
$.05 SHOWERS(per trap) BASE,STALL,ON—SITE BUILD x $6 = $
1306 SINKS LAVS/BASINS.BAR FLOOR KITCHEN X $6 = $ -
LAUNDRY,IJFILITY,JANITOR,PHOTO,
X—RAY,FOOD(PREP1CULINARY/MFAT)
Bol DISHWASHER - x $6 = $
1308 CLOTHES WASHER - x $6 = $
B09 GARBAGE DISPOSAUGRINDER - x $6 = $
B10 WATER SOFTENER - x $6 = $
B11 ELECTRIC HOT WATER TANKS (NOTE: if gas water tank see mechanical) X $6 = $
B12 FLOOR DRAINS AREA CASE,COIL,TRENCH,CONDENSATE x $6 = $
,B13 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $
13.14 FOUNTAINS,DRINKING - x $6 = $
131$WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION,ALTERATION,REPAIR, x $6 = $ ff
PLUMBING REVERSALS REVERSALS '_
131;6 SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $
1317 WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
HOSE BIB,STEAMER.PROOFER,
CARBONATOR,SWAMP COOLERS
B18 CROSS-CONNECTION DEVICES VACUUM BREAKER CHECK VALVE, x $6 = $
AND R.P.B.P.D.FOR:VATS SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS
I319 INTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $
CHEMICAL HOLDING TANK
1320 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $
B21 MISCELLANEOUS FIXTURES x $6 = $
NOTE: MINIMUMPERMIT FEE IS$35.00 Subtotal
PLUS: PROCESSING FEE $25.00
SIGNATURE: TOTAL PERMIT FEE DUE
PLEASE MAKE CHRGKS TA .E.
Spokane County Division of Buildings SPOKANE COiUNTY PERMIT CENTER::
1026 W. Broadway Avenue * Spokane,WA 99260
Tel. No.(509)456-3675 • Fax No.(509)456-4703*TDD No. (509)324-3166
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S p O K A N E {rglealk'+.isiiati C O U N T Y
OFFICE OF THE COUNTY ENGINEER • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
Ronald C. Hormann, P.E., County Engineer Dennis M. Scott, P.E., Director
MEMO
DATE: 10/17/94
TO: Jim Legat
FROM: Bill Johns 6
,L_____
RE: University Place ULID
All the lines are released for connection.
The following need to be released immediately:
1 . South 1 1 1 1 Mariam U - i .' '
2 . East 10602 14th
3 . East 10213 16th
1"• CQ J7 log/6 /2
1026 W Broadway Ave. • Spokane,WA 99260-0170 • (509)456-3600 FAX: (509)324-3478 TDD:(509)324-3166