2007, 09-11 Permit Application: 07003549 PlumbingPermit Center
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
j V,, (509)688 -0036 FAX: (509)688 -0037
Ql�ey www.spokanevalley.org
Community Development
Plumbing Permit Application n Commercial Residential
Spokane
PERMIT NUMBER:
PERMIT FEE:
SITE ADDRESS: S76 S . M L-K t
Building Owner a RA( 6— 5 L, E ,E 7W
Name:
C PA e lr
s t,EETN
Phone: e(S6, — 3 7 E.,
Fax:
Address:
t 7 A 7
, A 6 E2S
City: S .P0 KR N it
State:
w 0.
Zip: 79.4 al/
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
cl BRA 16-
S L r- E r#
Name:
C kiif
S GIE- ,E7771
Phone: vs—co —37£>'£g
DESCRIPTION OF WORK
1
TOILETS
2
URINALS
WATER CLOSET, BIDETS
# OF UNITS
X
COST
TOTAL AMOUNT
X
$6.00
X
$6.00
3
TUBS
X
$6.00
4
5
6
SHOWERS PER TRAP
SINKS
DISHWASHER
BATH, STALL, ON -SITE BUILT
7
CLOTHES WASHER
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
3
C
X
X
X
$6.00
$6.00
$6.00
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
i
X
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
C
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
l
X
$6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
16
WATER USING DEVICE
ICE AN /OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
$6.00
$6.00
$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
21
PRIVATE SEWAGE DISPOSAUSYS
X
$6.00
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
DCASH CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: