2013, 09-09 Permit App: BLD-2013-1803 Plumbing Fixtures0/(e?gy,- , at)0
Permit Center
Sp ®Wane 11707 E Sprague Ave, Suite 106
Talley Spokane Valley, WA 99206
V (509)688 -0036 FAX: (509)688 -0037
Community Development w.ww.spokanevalley.ora.com
Plumbing Permit Application
❑ Commercial Residential
SITE ADDRESS 17 30 1 E. & I U (,,Ji A-
$uildingoner
DESCRIPTION OF WORK
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Phone:
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Address:
$6.00
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TUBS
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SINKS
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
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Phone:
4211tXFIE1.110tr
Fax:
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Name: : _,-.,,
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Address:
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CLOTHES WASHER
City
State
Zip
License No:
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8
GARBAGE DISPOSAL
$6.99` r
City Business License No:
9
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Name:
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Phone:
11
FLOOR DRAINS
AUTHORIZED SIGNATURE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
3
X
$6.00
=
17
2
URINALS
X
$6.00
=
3
TUBS
2.
X
$6.00
=
12
4
SHOWERS (PER TRAP)
BATH, STALL, ON -SITE BUILT
X
$6.00
=
5
SINKS
LAVS /BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
1
x
$6.00
=
1
Z L1
6
DISHWASHER
1
X
$6.00-
-
"^6
7
CLOTHES WASHER
1 ' roJ
e X
X
$6.00
=
e
8
GARBAGE DISPOSAL
$6.99` r
_
9
WATER SOFTENER
x
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$y
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
ati.00
=
12
ROOF DRAINS /OVERFLOW --- - --
DRAINS
- - - - - -- -
$8:0R M
r
13
FOUNTAINS, DRINKING
x
$6.00
C
E N T
14
WATER PIPING/DRAIN -IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
SUB
f_
X
;
6.00
=
1
' / r-1
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
k6.00
=
16
WATER USING DEVICE
ICE AN /OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS
X
$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
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAVSYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
7
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05