2008, 09-16 Permit Application: 08003654 PlumbingPermit Center
S�,,,ne, 11703 E Sprague Ave, Suite B -3
Valley Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
Community Development perrnitcenter ,"&spokanevalley.org
Plumbing Permit Application n Commercial
PERMIT NUMBER: (gj
PERMIT FEE:
Residential
0
SITE ADDRESS:
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Building Owner
Name:
Phone:
Fax:
Address:
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City:
State:
Zip:
Contractor
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Name:
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Phone:
Fax:
Address:
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Clty. S�oL�
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State:
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Zip:
License No:
FA EE D p / O I / �t'
00 f^�
City Business
Contact
Name:
Phone:
DESCRIPTION OF WORK
it OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
URINALS
X
$6.00
X
$6.00
3
TUBS
X
$6.00
4
5
6
SHOWERS PER TRAP
SINKS
DISHWASHER
7
CLOTHES WASHER
BATH, STALL, ON -SITE BUILT
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
$6.00
$6.00
/DX
X
$6.00
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$6.00
10
11
12
ELECTRIC WATER HEATER
FLOOR DRAINS
ROOF DRAINS /OVERFLOW DRAINS
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
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
69, OD
15
16
17
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
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
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
X
X
$6.00
$6.00
$6.00
X
$6.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
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 ❑ CHECK
Card#
ISA ❑ MC
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
$35.00