2008, 05-05 Permit App: 08001697 Plumbing Fixtures7'Permit Center
Spokane � ane 11703 E Sprague Ave, Suite B-3
j Palley Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 PERMIT FEE:
Community Development www.spokanevalleyore
Plumbing Permit Application ❑ Commercial ,Residential
PERMIT NUMBER: I(CR,
SITE ADDRESS: 5 < 7 . A2 /).Q s' f
Building Owner.r.e col
Name:pr,
Phone:
Fax:
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Address: S, Al s 8,.S * Y'a
City: oo yi��
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State: ,A../.4,Zip:
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Contractor U ur G / ✓7 Q— .
Name:
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Phone: 92y SvgS
Fax:
Address: / 29/g C s,� �^
City: /��PP h 0i C -ref
State /}
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Zip. p9a /�
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License No: COi%t G C Of8 /
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City Business Lic:
Contact (Dvat1FZe- co Litt 2,7zaine
Name:
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Phone: !GZ Y -S yB1-
DESCRIPTION OF WORK
# OF UNITS X COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6.00
6.60
2
URINALS
x
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
6, b6
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
‘, 06
6
DISHWASHER
X
$6.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00
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
X
$6.00
r))
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
$6.00
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 DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH D CHECK D VISA D MC EXPIRES:.
Cardtt , VIN:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
SUBTOTAL
Z if, 00
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
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