2008, 05-28 Permit App: 08002008 Plumbing FixturesCommunity Development
Permit Center
11703 E Sprague Ave, Suite B -3
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
www.spokanevalley.org
Plumbing Permit Application
n Commercial tkj Residential
PERMIT NUMBER: KijZ.
PERMIT FEE:
SITE ADDRESS: /2) 60 F. /ni c}✓' $9 kaAt /q106
Building Owner
e <,t4 3s`1- 7-%'-'4.
Name:
ii `
bfo, tL12
Phone: � 7 i 7j(
7 /
Fax:
Address:
/St D E !410.1 ci W f;v\
City: JP73 KavLe
t%Ga(Pr,(
State:
i
Zip:
85266
Contractor
-•J
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
I j
)r6'&.0 -` ‘)CA hi
Phone: A 9' •C,
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
2
3
4
5
TOILETS
WATER CLOSET, BIDETS
X
$6.00
URINALS
TUBS
X
$6.00
X
$6.00
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON -SITE BUILT
X
$6.00
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
7
8
9
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL
WATER SOFTENER
$6.00
X
$6.00
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
11
12
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
ROOF DRAINS /OVERFLOW DRAINS
X
$6.00
13
14
FOUNTAINS, DRINKING
X
$6.00
WATER PIPING /DRAIN -IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
15
16
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
WATER USING DEVICE
ICE AN /OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
$6.00
17
18
19
20
21
22
CROSS CONNECTION DEVICE
INTERCEPTORS
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
$6.00
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
MISCELLANEOUS PLUMBING FIXTURE
PRIVATE SEWAGE DISPOSAL/SYS
X
$6.00
X
$20.00
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
WASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
Effective October 28, 2007
P: \Community Development\Forms\Building forms\Plumbing Permit Application.doc