2008, 07-29 Permit App: 08002932 Plumbing FixturePermit Center
Spokane 1707 E Sprague Ave, Suite 106
.0000 Mil lei
Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
Community Development ii.ow ,pokaneval ley ore
Plumbing Permit Application ❑ Commercial ,-Residential
PERMIT NUMBER: LM
PERMIT FEE.
/4
1 --
SITE ADDRESS: / 6 / 3 S - Ekt k -e
Building Owner
Name: TlrAA_
K et'. <.e. --e
Phone / Z8 31yv
Fax
Address' / 6 / 3
5 // )c k
City q
Spo KC ."-<._."-<._3/41 IC/ State ill// Lp / 9Z/6
R
Contractor
Name 1444 se
Lec,, cNSC CLI>G
Phone: Cl ZG • 795
Fax' / Z6 ,07_ -7 )
F
Address 1 Z1 of
e noc-pc
r d -
City 5PQKC..4 C
State vyA Zip 99 too
License No
City Business Lic
Contact
Name,
Phone
I
DESCRIPTION OF WORK
# OF UNITS X COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
36 00
2
URINALS
x
36 00
TUBS
X
56 00
4
SHOWERS /PER TRAP)
BATH. STALL, ON-SITE BUILT
X
56 00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN.
LAUNDRY, UTILITY, JANITOR. PHOTO,
X-RAY. FOOD. PREP/CULINARY MEAT
X
56 00
5
DISHWASHER
X
36_00
7
CLOTHES WASHER
X
56 00
8
GARBAGE DISPOSAL
X
56 00
9
WATER SOFTENER
x
$6 00
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
56 00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
x
56 00
12
ROOF DRAINS/OVERFLOW DRAINS
x
$6 00
13
FOUNTAINS. DRINKING
X
56 00
14
WATER PIPING/DRAIN-IN WASTE.
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56 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
X
56 00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B,P D FOR VATS, TANKS,
BOILERS
X
56 00
c , DO
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
21
PRIVATE SEWAGE DISPOSAUSYS
X
520 00
22
INDUSTRIAL WASTE INTERCEPTOR
X
315 00
METHOD OF PAYMENT:
OCASH 0 CHECK 0 VISA 0 MC
Card#
AUTHORIZED SIGNATURE:
RES ISED 8/26,05
EXPIRES
VIN
SUBTOTAL
l000
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
y/. 00