2006, 06-16 Permit App: 06002356 Plumbing Fixturesrermit (.enter
SP6kane 11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688 -0036 FAX: (509)688 -0037
Community Development ltiww-.sDokanevallev.ora
Plumbing Permit Application n Commercial
Valley
SITE ADDRESS: ( () 0 i,1
PERMIT NUMBER:
PERMIT FEE:
Residential
7/I rou
0
Building Owner
Name: / L Tr M T
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Phone: S 2 L) _
Fax:
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Address: i
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Zip: 1 c
Contracor :
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Name: ,
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Phone: 'L j,- 1 1
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Address: L1 0 24 r ) , Lc) j K
City. 5 ,
State:
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G''ci_ Zip: ) ? �e,,
License No: 1,4- ir� ;2 p 19 L ' L [ �
City Business Lic:
Contact' J4 ' C I .L . 14 -647/ _
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Name•
Phone: -1 - o ^ (!
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DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.D0
4
SHOWERS (PER TRAP)
BATH, STALL ON-SITE BUILT
X
$6.0D
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X -RAY, FOOD, PREP /CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
$6.DD
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$6.00
10
ELECTRIC HOT WATER TANK
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
$6.0D
13
FOUNTAINS, DRINKING
WATER PIPING/DRAIN -IN WASTE.
VENT, PLUMBING, REVERSAL
X
$6.00
14
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.DD
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
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
$6.0D
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6. DD
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
2D
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.0D
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED sn6i05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: