2009, 05-22 Permit App: 09001457 Plumbing ReversalP
G'\::,
1170311 Center
Spra
SiManGne E Sprague Ave,ASuite B-3
Spokane Valley, WA 99206
`,a,7 (509)688-0036 FAX: (509)688-0037
�"Cliley a'wW spokanevalleyotg
Community Development
Plumbing Permit Application •
❑ Commercial
PERMIT NUMBER: ) y 5 -
PERMIT FEE:
43
Residential
SITE ADDRESS: 'c /I/. 2?r_s 57 - ,sed
Building Owner
Name: -awe
Phone:
Fax
Address:
- 1
walliNralr.
State:
Zip:
Contractor
Name: TLC CONSTRUCTION
Phone: 509-456-3687
Fax:
Address: 9006 S. HAYFORD RD.
City: CHENEY
State: WA
Zip: 99006
License No: TLCCO•• 107M6
City Business Lic: 601263777
Contact
-
Name: TERRY COURCHA1NE
Phone: 509-456-3687
DESCRIPTION OF WORN
# OF UNITS X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
2
URINALS
x
$6 00
3
TUBS
X
56.00
4
SHOWERS (PER TRAP)
BATH, STALL ON-SITE BUILT
x
36.00
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
38.00
6
DISHWASHER
X
$8.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER .
X
36 00
.10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
46 00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
x
$6.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
5600
13
14
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
X
56 00
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
38.00
r.
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$8.00
18
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
58.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR' VATS, TANKS,
BOILERS
x
36.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
38.00
19"
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
38.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
36.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
320.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA C] MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
;35.00
TOTAL PERMIT FEE DUE: