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2004, 04-27 Permit App: BLD-04-04211 Plumbing Fixtures
Spokane coosValley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037- Fax For Inspections, call 509-688-0054 PROJECT �A ADDRESS. / I //IBJ ii S ia PERMIT USE: OWNER: il %k l PLA, 4. ALA, ) A (1 QL9 "-Y PHONE (Daytime Contact): MAILING ADDRESS: EQUALS AMOUNT (street) (city/state) (ZIP) cW-ecToLio 9 I (tAnfi I• fled LICENSE $6 MAILDING DR 3(-//. S. dc( PHONE tl:t qai s�/� URINALS (street) (city/state) (ZIP) PLUMBING FIXTURES METHOD 0 0 CASH DATE: BANKCARD NUMBER AUTHORIZED SIGNATURE. DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT I TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X Sb 4 SHOWERS (PER TRAP) BATH, STALL ON-SITE BUILT X $6 - 5 SINKS LAVS/BASINS, BAR, FLOOR KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X $6 - 6 DISHWASHER X 86 - 7 CLOTHES WASHER X $6 - 8 GARBAGE DISPOSAL X $6 - 9 WATER SOFTENER X $6 - 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6 - 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 14 SEWAGE EJELIOR GRINDER SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, ?ROOFER, CARBONATOR, SWAMP COOLER X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER CHECK VALVE, AND R.P B.P.D. FOR: VATS, TANKS, BOILERS X $6 17 SPRINKLER SYSTEM X $2.5 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK x *6 - 19 MEDICAL GAS per outlet ' NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT ] CHECK YISi' VISA' 77. ir -:;_•-. --?': SUBTOTAL: PLUS PROCESSING FEE: $35.00 ■ :',1.;L::a;. ■ TOTAL PERMIT FEE DUE: j (//0 DATE: BANKCARD NUMBER AUTHORIZED SIGNATURE.