2008, 12-05 Permit Application: 08004718 Flumbing FixturesPermit Center
spoi aile 11703 E Sprague Ave, Suite B -3
.0, 0Valley Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
Community Development www.spokanevallev.ortt
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
Commercial Residential
SITE ADDRESS:
Building Owner
Name: 1 /
�ti� 1'lv�
Phone: Fax:
�Z�`
Address: ) 51.21- (aerie )
City: J . t S /„s State:w A
Zip: GRG »
Contractor
Name: l:._. r, �rr dr-�
1 J� J��.l
Phone: *76 — 26-49 Fax:
Address: 6�
City: rune a State: j, 14
�7
Zip : /q6 --i;
License No: -57:) / T /� 6 Q el/ / - P
� K l /t
City Business Lic: 7 .. 4�
(F.3
J 0
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t
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Contact
(�
Name: C(f 0 Oaf"—
p
Phone: .76 Z6 /
1
DESCRIPTION OF WORK
TOILETS
WATER CLOSET, BIDETS
# OF UNITS X
COST
TOTAL AMOUNT
X
$6.00
=
2
3
4
5
6
URINALS
TUBS
SHOWERS PER TRAP
SINKS
DISHWASHER
7
CLOTHES WASHER
X
$6.00
X
$6.00
BATH, STALL, ON -SITE BUILT
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
$6.00
0 0
$6.00
X
$6 00
6
30
= i
X
$6.00
6
8
GARBAGE DISPOSAL
$6.00
b
9
WATER SOFTENER
X
$6.00
10
ELECTRIC WATER HEATER
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
15
16
17
18
19
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
INTERCEPTORS
MEDICAL GAS (per outlet)
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
GRINDER, SUMP PUMP
ICE AN /OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
NITROUS, OXYGEN
X
$6 00
X
X
X
$6.00
$6.00
$6.00
X
$6.00
X
$6.00
l>4
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAL /SYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
$15.00
METHOD OF PAYMENT:
❑CASH U -CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
108
$35.00