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HomeMy WebLinkAbout2007, 04-23 Permit App: 07001428 Residence Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: Permit Use: SFR W/ATT GAR Contact: CLIFF SCHMITZ CONSTRUCTION Address: 16520 E SECRETARIAT C-S-Z: VEREDALE,WA 99037 Setbacks:Front 33 Left: 6 Right: 8 Rear: 50 Phone: (509)999-7733 Group Name: Site Information: Project Name: Plat Key: Name: Range District: Sout Parcel Number: 45345.9149 Block: Lot: SiteAddress: 13014 E 39TH AVE Owner:Name: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Location::CSV VEREDALE,WA 99037 Zoning: UR-3.5 Urban Residential 3.5 Water District: 007 MODEL Hold: ❑ Area: 13.88 Acres Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review In formation: __ , Review Building Plan Review Released By.' Driveway/Approach Released By- '. " Landuse/Zoning/HE Conditions Released By: 0,7 Sewer Review Released B ; ` Permits: : 4w . z .. ., _,_. ., .M. Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 1 of 3 • THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ... m -aa.aa.r< artn.:�sa-...:wa Permit Use: SFR W/ATT GAR Contact: CLIFF SCHMITZ CONSTRUCTION Address: 16520 E SECRETARIAT C-S-Z: VEREDALE,WA 99037 Setbacks:Front 33 Left: 6 Right: 8 Rear: 50 Phone: (509)999-7733 Group Name: Site Information: Project Name: Plat Key: Name: Range District: Sout Parcel Number: 45345.9149 Block: Lot: SiteAddress: 13014 E 39TH AVE Owner:Name: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Location::CSV VEREDALE,WA 99037 Zoning: UR-3.5 Urban Residential 3.5 Water District: 007 MODEL Hold: ❑ Area: 13.88 Acres Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: _... �. , Review Building Plan Review Released B rj" /-jo ,7 Driveway/Approach Released By y N' Landuse/Zoning/HE Conditions Released a , Sewer Review ReleasedBy Permits: =macf:.o. w .4.s. •t - _:.• •• s ,y Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 1 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project In formation: Permit Use: SFR W/ATT GAR Contact: CLIFF SCHMITZ CONSTRUCTION Address: 16520 E SECRETARIAT C-S-Z: VEREDALE,WA 99037 Setbacks:Front 33 Left: 6 Right: 8 Rear: 50 Phone: (509)999-7733 Group Name: Project Name Site Information: �,�a n=om . ; _ m a 9�, �x rr Plat Key: Name: Range District: Sout Parcel Number: 45345.9149 Block: Lot: SiteAddress: 13014 E 39TH AVE Owner:Name: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Location::CSV VEREDALE,WA 99037 Zoning: UR-3.5 Urban Residential 3.5 Water District: 007 MODEL Hold: ❑ Area: 13.88 Acres Width: 0 Depth: 0 Right Of Way(ft): 0 Nbr of Bldgs: 0 Nbr of Dwellings: 0 Review Information: -,w ;:�. =, Review Building Plan Review Released By: ,.-j°' Driveway/Approach Released B " Landuse/Zoning/HE Conditions Rel aced By Sewer Review Released By ! _ Permits: ... .. .. .. -- s a a.-. . . _ _ x Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 2 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Building Characteristics Building Height 25 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation 1&2 FAMILY R-3 VB /S,v.,h9— $145,901.92 1,597 $145,901.92 2ND FLOOR R-3 VB 725 . 85 $51,155.80 685 $51,155.80 BASEMENT F R-3 VB 40 $800.00 40 $800.00 BASEMENT U R-3 VB ,3.1'/ l $23,355.00 1,557 $23,355.00 DECK -N Co✓ R-3 VB /?( k4$ $2,100.00 140 $2,100.00 GARAGE U-1 VB ol< 528 $10,032.00 528 $10,032.00 Totals: 4,547 $233,344.72 4,547 $233,344.72 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $1,744.15 WSBC SURCHARGE 1 SELECT $4.50 SF PLNS RVW<7999 SQ FT 1 SELECT $697.66 Permit Total Fees: $2,446.31 Mechanical Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Item Description Units Unit Desc Fee Amount GAS WATER HEATER 1 NUMBER OF $10.00 GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00 GAS PIPING 3 #OF UNITS $3.00 AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00 VENTILATING FANS 4 NUMBER OF $40.00 EVAPORATIVE COOLERS 1 NUMBER OF $10.00 GAS LOG OR GAS INSERT 1 NUMBER OF $10.00 Permit Total Fees: $105.00 Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 2 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Building Characteristics Building Height 25 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation 1&2 FAMILY R-3 VB 1,597 $145,901.92 1,597 $145,901.92 2ND FLOOR R-3 VB 685 $51,155.80 685 $51,155.80 BASEMENT F R-3 VB 40 $800.00 40 $800.00 BASEMENT U R-3 VB 1,557 $23,355.00 1,557 $23,355.00 DECK OPEN R-3 VB 140 $2,100.00 140 $2,100.00 GARAGE U-1 VB 528 $10,032.00 528 $10,032.00 Totals: 4,547 $233,344.72 4,547 $233,344.72 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $1,744.15 WSBC SURCHARGE 1 SELECT $4.50 SF PLNS RVW<7999 SQ FT 1 SELECT $697.66 Permit Total Fees: $2,446.31 Mechanical Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Item Description Units Unit Desc Fee Amount GAS WATER HEATER 1 NUMBER OF $10.00 GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00 GAS PIPING 3 #OF UNITS $3.00 AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00 VENTILATING FANS 4 NUMBER OF $40.00 EVAPORATIVE COOLERS 1 NUMBER OF $10.00 GAS LOG OR GAS INSERT 1 NUMBER OF $10.00 Permit Total Fees: $105.00 Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 2 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Building Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Building Characteristics Building Height 25 This Application: Total Project: Description Grp Type Notes Sq Ft Valuation Sq Ft Valuation 1&2 FAMILY R-3 VB 1,597 $145,901.92 1,597 $145,901.92 2ND FLOOR R-3 VB 685 $51,155.80 685 $51,155.80 BASEMENT F R-3 VB 40 $800.00 40 $800.00 BASEMENT U R-3 VB 1,557 $23,355.00 1,557 $23,355.00 DECK OPEN R-3 VB 140 $2,100.00 140 $2,100.00 GARAGE U-1 VB 528 $10,032.00 528 $10,032.00 Totals: 4,547 $233,344.72 4,547 $233,344.72 Item Description Units Unit Desc Fee Amount RESIDENTIAL PERMIT FEE 1 SELECT $1,744.15 WSBC SURCHARGE 1 SELECT $4.50 SF PLNS RVW<7999 SQ FT 1 SELECT $697.66 Permit Total Fees: $2,446.31 Mechanical Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Item Description Units Unit Desc Fee Amount GAS WATER HEATER 1 NUMBER OF $10.00 GAS APPLIANCE<=100,000BTU 1 NUMBER OF $12.00 GAS PIPING 3 #OF UNITS $3.00 AIR CONDITIONER:4-15 TONS 1 NUMBER OF $20.00 VENTILATING FANS 4 NUMBER OF $40.00 EVAPORATIVE COOLERS 1 NUMBER OF $10.00 GAS LOG OR GAS INSERT 1 NUMBER OF $10.00 Permit Total Fees: $105.00 Operator: JD Printed By: JD Print Date: 4/23/2007 Project Number: 07001428 Inv: 1 Application Date: 4/23/2007 Page 3 of 3 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Plumbing Permit Contractor: CLIFF SCHMITZ Firm: CLIFF SCHMITZ CONSTRUCTIO Address: 16520 E SECRETARIAT Phone: (509)922-4297 VERADALE WA 99037 Item Description Units Unit Desc Fee Amount TOILETSBIDETS 3 NUMBER OF $18.00 SINKS 6 NUMBER OF $36.00 SHOWERS 1 NUMBER OF $6.00 TUBS 2 NUMBER OF $12.00 DISH WASHERS 1 NUMBER OF $6.00 GARBAGE DISPOSAL 1 NUMBER OF $6.00 CLOTHES WASHER 1 NUMBER OF $6.00 FLOOR DRAINS 1 NUMBER OF $6.00 MISCELLANEOUS FIXTURES 3 NUMBER OF $18.00 Permit Total Fees: $114.00 Payment Summary' Permit Type Fee Amount Invoice Amount Amount Paid Amount Owing Building Permit $2,446.31 $2,446.31 $0.00 $2,446.31 Mechanical Permit $105.00 $105.00 $0.00 $105.00 Plumbing Permit $114.00 $114.00 $0.00 $114.00 $2,665.31 $2,665.31 $0.00 $2,665.31 Disclaimer: Submittal of this application certifies the owner(or person(s)authorized by the owner)has both examined and finds the information contained within to be true and correct,and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for,or an approval of,any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: JD Printed By: JD Print Date: 4/23/2007 Permit Center PERMIT NUMBER: v� Spa`�kane000094\41,. 11707 E Sprague Ave,Suite 106C����iCn .000 valley lley ( Valley,WA 99206 �1--((GG 11//GGtt�d PERMIT FEE: Y"d -0036 FAX:(509)688-0037 Community Development www.spokanevalley.org.com - ng07 SPO NE VALLEY Residential Construction '` ` ' 'TPdR, ruction o Accessory Bldg Permit Application o Addition/Remodel o Deck o Other: SITE ADDRESSO P! nC 2 i 3 r( 1 sq l'A ASSESSORS PARCEL NO: LEGAL DESCRIPTION: LOT 13 Q&K3 Alt- Building owner Contractor rte+ Name: C& 1tcG ScAmIiz, 5T �LNc M. Name: Address: /6 S Z_0 6., S>>: �7if Address: City: �1A-i-e Zip: 9626 39 City: Zip: n Phone: Fax: /�nq Phone: "1`7'7" 9933/33 Fax: 81/-q q 7 Lic No: CL.gSc Cj37slOExp.Date: y- Z009 Contact Person- City Business Lic No: Name: Ca L.1 RF 5 Chir»11 Phone: Cost of Project: $ I nn the scope of work in detail: I Describe p I�Si er1CP. ( )C42") **************The following MUST be complete: (write N/A if not applicable)********************** HEIGHT TO PEAK: DIMENSIONS: #OF STORIES: TOTAL HARITABLE SPACE: MAIN FLOOR TO SQ. 2 "FLOOR SQ. FTG: UNFIN BASEMENT SQ. FTG: IMPERVIOUS SURFACE FTG: / gi c s9 AREA: e- FINISHED BA_ EMENT GARAGE a FTG: DECK/CLO/V. PATIO SQ. FTG: 30% SLOPES ON SQ. FTG: Y6 Sl a j 7� 0 PROPERTY: $ #OF BEDROOMS: CONSTRUCTION TYPE: HEAT SrOURCE: SEWER OReSSEPTIC? DISCLAIMER The permitee verifies,acknowledges and agrees by their signature that: 1) If this permit is for construction of 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) This City of Spokane Valley Permit is not a permit or approval for any violation of federal,state or local laws,codes or ordina ces 6) Pla s or additional information may be required to be submitted,and subsequently approved before this application can be ,r•'es •d/ /jaw Date 41-i 11'Of) Signature .�A Method of Pay - (Faxed pe it applications will only be accepted with major bankcard) ❑ Other Cash 0 Ch-ck 0 Mastercard 0 VISA 0 Bankcard#: Expires: VIN#: Authorized Signature: REVISED 8252005 2001 WSEC.Residential Compliance Form Prescriptive(Chapter 6) Options for all R Occupancies,Cyanate Zone 2 0; 1 Heat source: ALL City of - SPOKANE VALLEY BUIL•DIP4TG DEpATMENT -11707 E.Sprange Avenue,4106,Spokane Valley,Washington 99206-Tel 509-921-1000-Fax 509-921-1008 SITE ADDRESS:_1301.4_--- PERMIT NO. DATE: _q_-1W INSTRUCTIONS 1) Your permit will processed mre efficiently yo provide requested all of the Department help you with eneral uesdions about this youYuildng mt match the selected option requirements without -exceptions or substitutions_ 2) Glazing percentage determines which option to choose- Complete the following glazing area calculation before proceeding to the option table below_ GLAZING AREA CALCULATION: = %I SF- -•-- 4- __a-a-9-----g------- SF- `2� (ALL FLOORS) _ %OF GLAZING TOTAL WINDOW AREA HEATED FLOOR AREA NOTE: Use rough opening(RIO)for window area. Include all half-lite and full-lite door glazing in this - - calculation- ty juggle CANT COMPLY? If none of the Prescriptiv (Chapter A6)rOph Thbee mainw are advantagebiseflex bider tose� lnalysis rtdividual(Chapter ( - or,Component Performance maximum (Chapter ) PP uirements. Calculations may be performed by hand or,using an acceptable ce ble U- factors(R-values) as long as an overall rvalue isn't exceeded_ Note that the overall performance requirements are no less stringent than the Prescriptive q www.e gy • computer software program- Helpful forms and other resources can be downloaded at http-// • buildings- i a SKS Ilcy Wall. Wall Wall-int ext 5 Stab`on Glazing Door' ceiling Valuted Above Below Below floor lGrade ab o 121 Option greFloor of Overhea1:1d" U factor Ceiling Grade Grade Grade Floor R-10 1210% 0.40 0.58 0.20- R-38 R30 R-12 R-30rn © R T R-21 R-12 t R-30 R 10 Z 0.20 R-38 R-30 R 5° I >4 1 u I 15% 0.40 0.58 Mill R-10 CI 0.37 0.58 0.20 R 38 R-30 RR 5° R 30 0 �® U� R-21 R-30 R-10 U Group R� 0.35 0.58 0.20 a_30 uhf' C>•. © Ory �/ __ titin accordance with Section 6011 Only lin E i.( les only or assemblies has a glazingithratio to the conditionedfloor area of 13%,it O • 0• Nominal R hru irements for each option example.it a proposed design which ccrreet the r ecific q • 1- shad co" of the 15%glazing option(or higher)- P qhs' 0 W shad remelt with an to the coning calculate COm by Chapters 4 or 5 of this Code- 2 R ofap eeo option above,net Adv'denotes Advanced Framed CaTug. V to at ceilings except single rafter orjoist-vaulted ceilings. . moment appf��only to single rafter or joist vaulted ceitngs. w F. 3. Begrito a minimae level of R-12,or on the interiorthe for sluse,its intended l s walls and above 4. g grade saps spall be insulated either on the exterior instated ^^ ,, Q Exterior insulation installed on below grade walls shall be a water resistant material manufactured Ci) Il a See Section 6022_ �q a�n9 to�rrer>lifar�rers to� rtthient air conditions. instated according to 4 5. Floors over crawl spaces or atratenal,�ranufadured for its intended use.and • F 4 ()i 6: Required s perimeter insulations shall be a water resistant \ H manufacturer's specifications_ 7. Int denotes standard framing 16 inches on center with headers in bullus with -5 foam sheathing. 9. -5 insulation_ 8. This wail insulation req doors,t denotes R-1sig dl cavity fromTable 10-6C. t gross oondtioned floor area including all fire doors,shall be assigned vertical plus overhead)as a percent COOfs• area is fisted,the total glazing area(combinedarea limitations. 10. s Where b a less than or equalwith U-factor of t--4.40 or less is not and glazing shop be fd glazing than have U-factorsthat terpin ad glazing roe with NFRC 100 or as specified shall have detemrined in.-acconda t form this insiAation requUe�h t .5. 11. Overhead galls with a minimum average thidO%ess or 3.5-are exempt t 2 Log and sold tirc'ber Form 5-050801-200 1 Residential Comp Form S, >an e 11707E Sprague Ave,Suite 105 PERP NIiBER: Valley Spokane Valley,WA 9'9205 (509)688-0036 FAX:(509)688-0037 PERMI I FEE: CommunitYDevelopment www.svokanevallev.ore ReSlClentlal Mechanical Permit Application ❑ Commercial SITE ADDRESS: Builcling Owner Phone: Fax: Name: City: State: P: Address: • Contractor,, NOM - Fax.: - J�"�r� Phone: Name: � State: Zip: City: Address: License No: City Business Lie: Phone: Name: #OF UNITS X COST 1 = I TOTAL AMOUNT DESCRIPTION OF WORK I X $1200 = 1 FUEL BURNING APPLIANCE Equal to or less than 100,000 = More than 100.000 . X $15.00 2 FUEL BURNING APPLIANCE More X $50.00 = 3 UNLISTED APPLIANCE(Additional Fee) Equal to or less than 400,000 X $100.00. = 4 UNLISTED APPLIANCE(Additional Fee) More than 400,000 5 USED APPLIANCE(WSEC min.AFUE rating) Equal to or less than 400.000 X $10X $50..00 = 6 USED APPLIANCE(WSEC min.AFUE rang) More than 400,000 = 100M BTU X $1200 7 BBOILER/REFRIGERATION1- X $20.00 = B BOILER/REFRIGERATION 101-500M1 BTU = 501-1,000M BTU X $25.00 9 BOILER/REFRIGERATION X $35.00 = 10 BOILER/REFRIGERATION 1,001-1,75DM BTU = More than 1,750M BTU X $60.00 11 BO►LER/REFRIGERATION I X $10.00 = 12 GAS LOG,GAS INSERT,GAS FIREPLACE X $10.00 = 13 RANGE X $10.00 = 14 DRYER I X $10.00 = 15 FUEL BURNING WATER HEATER X $10.00 = . 16 MISC.FUEL BURNING APPLIANCE X $1 0 = 17 GAS PIPING(each outlet) X $10.00 = 18 DUCT SYSTEMS 7 X $10.00 = 19 VENTILATING FANS = 20 AIR HANDLER(DOES NOT include ducting) to or less than 10,000 CFM X $12.00 inq) EqualX $15.00 = - 21 AIR HANDLER(DOES NOT include ducting) Greater than 10.000 CFM f X $10.00 22 EVAPORATIVE COOLERS X $10.00 = 23 TYPE I HOOD X $10.005 = 24 TYPE II HOOD X $12.00 = 25 HEAT PUMP/AIR CONDITIONER 0-3 TON = 26 AIRCONDmONER 3-15 TON -! X $20.00 = 27 AIR CONDITIONER15-30 TON X $35.00 = 28 AIR CONDITIONER 30-50 TON 29 AIR CONDi'f10NER More than 50 TON X $60.00 X $10.00 = 3D LPG STORAGE TANK X $10.00 = 31 WOOD OR PELLET STOVE/INSERT X $10.00 = 32 WOOD STOVE-FREE STANDING X $15.002 = 33 REPAIR&ADDITIONS X $12.00 = 34 VENTILATION SYSTEMS X $12.00 = 35 VENTILATION MECHANICAL EXHAUST X $19.00 = 36 INCINERATOR-RESIDENCE X $22.00 = 37 INCINERATOR-COMMERCIAL SUBTOTAL METHOD OF PAYMENT: $35.00 EXPIRES: PROCESSING FEE DCASH 0 CHECK D VISA DMC VIN: TOTAL PERMIT FEE DUE: CARD ft: AUTHORIZED SIGNATURE: REVIS D arzc✓os 7:,.tu.... PER�YiII NUMBER `C L 7 7e 3Pokme Valley,WA 99206 Ydl� (509)588-0036 FAX:(509)6E3-0037 PERMIT I-EE: Community Development WWW wok anevaTiev.or. :- c�_.y: Plumbinlb Permit Application Commercial Vi Residential SIL 1.ADDRESS: Building Owner • Name: Phone: Fax: Address: City: State: Zip: Contractor Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: DESCRIPTION OF WORK _ S OF UNITS X COST = TOTAL AMOUNT - 1 TOILETS WATER CLOSET,BIDETS 3 _ X $6.00 = 2 URINALS X_ $6.00 = 3 TUBS _ Z., X $6.00 = J 4 SHOWERS(PER TRAP) _ BATH,STALL.ON-SITE BUILT _ I 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 I X $6.00 - 7 CLOTHES WASHER _ 1 X $6.00 = , B GARBAGE DISPOSAL I X $6.DD = , 9 WAI LK SOFTENER . - X 56.00 = 1D - ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X $6.DD = AREA,CASE,COIL TRENCH. 11 FLOOR DRAINS CONDENSATE ' X $6.DD = , 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 $5.00 = ICE AN/OR COFFEE MAKER HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, AND RP_B_P_D.FOR VATS.TANKS, 17 CROSS CONNECTION DEVICE BOILERS X $6.00 = _ GREASE TRAP,SAND TRAP, 16 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 DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 ._ = SUBTOTAL METHOD OF PAYMENT: _ PROCESSING FEE DCASH 0 CHECK D VISA DMC EXPIRES: $35.00 Card# V1N: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26155 i $O 96 0 4 i f CC id 'i3 - E`- •" CIS 40t - 0• o 2. t \ jk)121Q1 ter) b s-- O. En V $ C'‘ \--r-) 6eig Mt L T 13 el 1 4160 6LK 3 4 ...ttori r ' _ _____ _______ 13 b IL( te 39-rL ,...._ 1k, 0to 24 1 I 1 i" = zo` ,..-- PLANNING DEPT. ' PPROVED1\t ----- ' 2q BY. Atigaw ------------* DATE: 41/3970-)