2006, 03-16 Permit Application: 904 PlumbingPermit Center
Stiokane 11707 E Sprague Ave, Suite 1
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)6
Community Development www.spokanevallev.org
Plumbing Permit Application
MAR 1 6 2006
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(lJ LI L I o) I) W. Si'
PERMIT NUMBER: 1
PERMIT FEE:
n Commercial H.Residential
SITE ADDRESS: a O i Z S, A M,
Building Owner
Name: Fe--
Phone:
Fax:
Address: Aoi z_ 3. A_ d 40, s
City: s3pipa
\A 1 1 State: 1.11H
Zip: ? q 0 $ i
Contractor _.. -
° _.
_....
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Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name: ,lc AE_/)/ s
Phone: 5 4 ,--
,5 Z- z "qt.)/
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
1
X
$6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6.00
5
SINKS
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$6.00
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
ROOF DRAINS /OVERFLOW DRAINS
X
$6.00
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING /DRAIN -IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
$6.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
$6.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
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
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED W26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
v,