2008, 03-28 Permit Application: 07003641 Plumbing FixturesPermit Center
Spokane
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
Community Development www.spokanevalley.ore
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
n Commercial ❑ Residential
SITE ADDRESS: O)' ,._
Building Owner
Name: IAw ; c�,� e k�( _A-
Y
Phone:
Fax:
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Address:
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City: C ^ t
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State: WN`
Zip: 64.c
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Contractor
Name: C- \ t ., l R
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Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
IN
Name: V n v x 1T... e ,---xr', ,"C�
Phone: Z212
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DESCRIPTION OF WORK
1
TOILETS
WATER CLOSET, BIDETS
# OF UNITS
X
COST
TOTAL AMOUNT
2
URINALS
3
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
6
X
1
X
$6.00
$6.00
$6.00
1
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
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
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
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 DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
$15.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
Vg
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
0,6)