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2002, 03-08 Permit App 02001459 Sewage EjectorProject Number: 02001459 Inv: 1 Application THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Project Information: ...................................................... Permit Use: SEWAGE EJECTOR Setbacks: Front Left: Right: Rear: Site Information: Plat Key: 001288 Name: HUTCHINSON'S ADD Date: 3/8/2002 Page 1 of 2 ............................................................................................ Contact: TEEPLES, AUDI Address: 8523 E BROADWAY AVE C - S - Z: SPOKANE, WA 99212 Phone: (509) 927-8277 Group Name: Project Name: District: F Parcel Number: 45181.1525 Block: SiteAddress: 8605 E BROADWAY AVE SPOKANE, WA 99212 Location:: SPO Zoning: UR 3.5 Water District: Lot: Owner: Name: TEEPLES, AUDI Address: 8523 E BROADWAY AVE SPOKANE, WA 99212 Hold: ❑ Area: 0 Sy Ft Width: 62 Depth: 311 Right Of Way (ft): 40 Nbr of Bldgs: 0 Nbr of Dwellings: 1 Review , Special Review Hf'Cl � G [Released By" Contractor: OWNER Item Description SEWAGE EJECTOR PROCESSING FEE MINIMUM FEE ADJUSTMENT Plumbing Permit Firm: OWNER Phone: Units 1 1 Unit Desc NUMBER OF Y OR BLANK Select Permit Total Fees: Fee Amount $6.00 $25.00 $4.00 $35.00 Operator: DMD Printed Bv: DMD Print Date: 3/8/2002 Project Number: 02001459 Inv: I Notes: Application Date: 3/8/2002 Page 2 of 2 THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Payment Summary::;.:........ Permit Type Plumbing Permit Fee Amount Invoice Amount Amount Paid Amount Owing $35.00 $35.00 $0.00 $35.00 $35.00 $35.00 $0.00 $35.00 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 contrued 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. Signatu re: Operator: DMD Printed By: DMD Print Date: 3/8/2002 PLUMWNG PERMIT APPLICATION - PROJECT ADDRESS: OWNER: PERMIT USE: PHONE (Daytime Contact): MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: LICENSE: MAILING ADDRESS: PHONE: (Street) (City/State) (Zip) PLUMBING FIXTURES DESCRIPTION DETAIL # OF UNITS MULTI- PLIED BY COST/ UNIT EQUALS AMOUNT TOILETS WATER CLOSETS, BIDETS x $6 1-13 URINALS x $6 TUBS x $6 I05° SHOWERS (per trap) BATH, STALL, ON -SITE BUILD x $6 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD (PREP/CULINARY/MEAT x $6 DISHWASHER x $6 >B011=s B09 B12:. !B13i;; B14'r B15. B16: CLOTHES WASHER GARBAGE DISPOSAL/GRINDER WATER SOFTENER x x x $6 $6 $6 ELECTRIC HOT WATER TANKS (NOTE: if gas water tank see mechanical) x $6 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE x $6 ROOF DRAINS/OVERFLOW DRAINS (ea.) x $6 FOUNTAINS, DRINKING WATER PIPING/DRAIN-IN WASTE- VENT/PLUMBING REVERSALS INSTALLATION, ALTERATION, REPAIR, REVERSALS x x $6 $6 SEWAGE EJECTORS WATER USING DEVICES GRINDER, SUMP PUMP ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLERS x x $6 $6 CROSS CONNECTION DEVICES VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR : VATS, SUMPS, TANKS, BOILERS, & SPRINKLER SYSTEMS $6 B19; B20. B21, INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK x $6 MEDICAL GAS (per outlet/bottle station) MISCELLANEOUS FIXTURES NITROUS, OXYGEN x $6 $6 METHOD OF PAYMENT ❑ CASH ❑ CHECK ❑ . ❑ - ❑ FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT OF A MAJOR CREDIT CARD DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: SUBTOTAL PLUS PROCESSING FEE $ 25.00 TOTAL PERMIT FEE DUE MINIMUMPERMTlFEEIS 83500'` PLEASE MAKE CHECKS PAYABLETO.,..' SPOKANE COUNTY PERIvTIT GENT ER .' Spokane County Division of Building & Code Enforcement 1026 West Broadway Avenue * Spokane, WA 99260-0050 Telephone No. (509) 477-3675 * Fax No. 477-7198 TDD No. (509) 477-7133