2007, 07-17 Permit App: 07002756 Plumbing FixturesPermit Center
SQiikane 11707 E Sprague Ave, Suite 106
' j Valley Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.sookanevallev.org
PERMIT NUMBER: -2:15-
SITE
l5-
PERMIT FEE: / 2-
Plumbing Permit Application in Commercial Residential
SITE ADDRESS:
13..Ei S. 3s rr/In,4i
Building Owner
-
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Name:fo
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Phone:
Fax:
Address • aolC/ /0117q
7 r7q
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City: 1/6-
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State'
it 4j
Zip: (790 7
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Contractor . I
Name: 1 I4
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Phone:
Fax:
Address: ,
City:
State
Zip.
License No:
City Business Lic:
Contact - _
-
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- .
Name
Phone:
DESCRIPTION OF WORK
# OF UNITS X
COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6.00
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2
URINALS
X
$6.00
3
TUBS
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT '
2-
X
$6.00
X
' $6.00
5
SINKS
LAVS/BASINS, BAR. FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
1
X
$6.00
2-
6 6
DISHWASHER
X
$6.00
1'
7
CLOTHES WASHER
x
$6.00
8
GARBAGE DISPOSAL
X
$6 00
1,'
9
WATER SOFTENER
X
$6 00
10
ELECTRIC WATER HEATER
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 00
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
i
X
$6 00
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
3
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 DISPOSAL/SYS
X
$20 00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15 00
METHOD OF PAYMENT:
❑CASH ❑ CHECK 0 VISA 0 MC EXPIRES.
Card# VIN,
AUTHORIZED SIGNATURE•
REVISED S12W05
SUBTOTAL
PROCESSING FEE
%,y
$35.00
TOTAL PERMIT FEE DUE:
0
/ace