2004, 09-10 Permit App: BLD-04-07613 Plumbing FixturesSmpolmne
jMilley
Project Address: 4/12_ N • g otos
Owner. /.fro- -pr„_,
Mailing Address:
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSP✓rCTIONS, CAIS. (509) 688-0054
Permit Use:
Phone (Daytime Contact):
Contractor: c- `"" - 45
Mailing Address:
City
State
License #: Phone #:
Zip Code
City
State
BANKCARDNUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
*OF
UNITS
X
COST
im
TOTAL.
AMOUNT
1
TOILETS
WATER CLOSET BIDETS
x
56.00
=
(ti,_ 00
2
URINALS
X
$8-00
3
TUBS
/
X
$8.00
=
6-00
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
- $8.00
=
5
SINKS
LkVSBASINS, BAR, FLOOR
KITCHEN, LAUNDRY, UTILITY,
JANITOR. PHOTO, X-RAY, FOOD.
PREP/CULINARY/MEAT
/
X
$6.00
=
/_ ..00
(�
8
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
$6.00
=
B
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
56.00 .
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
(.0 - 0 0
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
56.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER,'CHECK
VALVE, AND R-P.B.P.D. FOR '
VATS, TANKS, BOILERS
X
$8.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
. CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
-
X
56.00
=
METHOD OF PAYMENT:
0 CASH Q CHECK Q VISA Q MASTERCARD
DATE EXPIRES:
SUBTOTAL
9-4-0
PROCESSING FEE
$35.00�11
TOTAL PERMIT FEE DUE:
5"I.16
BANKCARDNUMBER:
AUTHORIZED SIGNATURE:
Zip Code