2003, 07-23 Permit App BD-03-836 Garage, Plumbing07/23/03 08:20
$509 927 4062
SPO.STRUCTURES
Z 004/008
City of C9 is b 003 CP
SPOKANE VALLEY
IxCo37
PERMIT# /5/c)03-�3�_
BUILDING PST APPLICATION
Box•1 OWNER -S �Jd JOB LOCATION 5 '' $', 11.4WCvs*.1;04a6.2 d/`1 Zke#
o
OWNER'S ADDRESS ��vn'CITY PHONE
DESCRIBE JOB 90 % 'F a . / (_ lam/ 4 old
BOX 5 ESTIMATED PROJECT COST $
EXISTING BLDG. VALUATION $
THIS PROPERTY IS OWNED BY: SINGLE/MARRIED
—-PARTNERSHIPCORP.
BOX 2 CONTRACTOR'S NAME S,/�O----"-=_====`----__.�_____ _
� Gto 6-fue./7J e, EKG- PHONE 9o77-O65-5
CONTRACTORS ADDRESS 570 /(/. (/11z•)/(4Gj i /. CITY ,Siokabt¢ c r.,* g920‘
CONTRACTOR'S REG.#�OOI<(S gyp. EXPIRATION DATE Z -ob4 •
SOX 3 CONTACT PERSON OF PROJECT
__—__^_`— __ (CARD MUST BE PRESENTED AND COPIED OR VE TIED)p — ---
4 Lam/ < PHONE q.2 -OAS$
-- ADDRESS_ /p,/Ca. -
______ _--__—--- �CfTY S4---il��o ---- ZIP ajf20lo
BOX 4 SEWER AVAILABILITY — WATER AVAILABILITY __ ! —
BOX 6 PROPERTY TAX ACCOUNT NUMBER
LEGAL DESCRIPTION
(IF NECESSARY, PLEASE SUBMIT A SEPARATE PAGE WITH THE LEGAL DESCRIPTION) .,
• CENSUS NUMBER LOT NUMBER
( ). COMMERCIAL / INDUSTRIAL TOTAL AREA OF PROPERTY
- A( ) TENANT IMPROVEMENT IMPERVIOUS SURFACE il SQ FT.
__ ____ • -_ SQ. FT.
•
BOX 9 PLUMBING FIXTURES (Including rough -ins) MECHANICAL APPLIANCES ________
PLEASE USE THE ATTACHED PLUMBING / MECHANICAL FORM FOR THE LISTING OF ALL APPLIANCES.
SYSTEMS, HEATING AND AIR UNITS, FIREPLACE INSERTS, WATER HEATERS. CONVERSION BURNERS,
-LAWN SPRINKLER SYSTEMS, BACK FLOW PREVENTERS, ET AL.
3OX 10 Water Service meter size (if known) -- ~' Also see BOX 4 - `
BOX 7 BUILDING SQUARE FOOTAGE (Existing / proposed)1ST FLOOR
/ 2ND FLOOR /
3RD FLOOR / OTHER ' / BASEMENT FINISHED
BASEMENT UNFINISHED / DECK
/ GARAGE /
CARPORT / TOTAL / HEIGHT TO PEAK OF BUILDING _ FT.
BOX 8 ( ) SINGLE FAMILY = T---_=
( )MULTIFAMILY (NO. OF UNITS (X) NEW CONSTRUCTION
• ( ) EXISTING STRUCTURE
30X 11 Septic Tank - Not generally allowed in the City of Spokane Valley. For special circumstances contact
Your sewer purveyor and the Health District (See BOX 4)
10X 12 Street use may require a " Street Use Permit' for sewer, water, sidewalks, curb cuts. Contact the public
Works Department
VERIFY UNDER THE PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND '
ORRECT TO THE BEST OF MY KNOWLEDGE AND FURTHER THAT l AM AUTHORIZED BY THE OWNER OF THE
BOVE PREMISES TO PERFORM THE WORK FOR WHICH THE PPL1CATION IS MADE n N
WNER/AGENT
DATE
JUL 20 2003 09:26
r7:23-03
(OVER)
509 927 4062 PAGE.04
METHOD OF
❑ CASH
DATE:
Spokane
.00VaHey
Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT L / /
ADDRESS: �� 7 � . 1:1 ti er- r✓��
PERMIT /
USE: �/c ,� 1 Cam. ' � .. y if / 1
G, 4, /^G_�
�.
OWNER �� /.✓G r -al,"
/i'
PHONE (Daytime Cont
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR: ;/ p
p87C�,,r t' S flu t G, �'S
LICENSE #:
MAILING ADDRESS:
/.
S7G`� ,'4/L AJ d7CG.o
PHONE #: i
S Y
c,:.a 7.-(i
�i
(street) (city/state (ZIP)
PLUMBING FIXTURES
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
%
X
$6
-
2
URINALS
/
X
$6
-
4�
3
TUBS
X
$6
-
4
SHOWERS (PER TRAP)
BATH, .STALL, ON -SITE BUILT
/
X
86
-
C--'
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
,
/
X
$6
-
/
. '
6
DISHWASHER
X
$6
-
7
CLOTHES WASHER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
10
ELECT. HOT WATER TANI(
NOTE: IF GAS, SEE MECHANICAL
X
$6
-
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
-
12
FOUNTAINS, DRINKING
X
$6
-
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
-
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
RP.B.P.D. FOR: VATS, TANKS, BOILERS
X
$6
-
17
SPRINKLER SYSTEM
X
$25
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISG PLUMBING FIXTURE
X
$6
-
PAYMENT
] CHECK
11111.1.10
SUBTOTAL:
/ o, `3
-:...:
,rite
Y .'
PLUS PROCESSING FEE:
'
$35.00-�'
❑ II_.
TOTAL PERMIT FEE DUE:
/, C)e)
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
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ADDRE S 6-13oJ
PLANS FOR y-Gj
OWNER
DATE S BMITTED D APPROVED 7?3
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