2004, 06-09 Permit App: BLD-04-04543 PipingPLUMBING 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 INSPECTIONS, CALL. (509) 688-0054
Project Address: / 3 3 A/ . 1366704; 6 Permit Use:
Owner: /;,,41-r,•'/4.ee.-7
Mailing Address: (34/. ,
Phone (Daytime Contact):
V4 -L'
City State Zip Code
Contractor: /9:1 n?/4-//E; ._exie;KP License #:-.9.76.e4 5597644 Phone #: 6?/- ZEJC
Mailing Address: /?0, /cee
(/6-te/4
City
4-c)19.
State
9q037
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Irmind
DESCRIPTION ()%-.WRK
-...—
*OF
UNITS
X
COST
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$8.00
-01—
2
URINALS
X
$8.00
=
3
TUBS
X
$8.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
---0#--
X
$6.00
=
PREP/CULINARY)MEAT
6
DISHWASHER
X
$6.00
-
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$6.00
= ,
9
WATER SOFTENER
X
$6.00
k = 1
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
r
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
=
i
12
ROOF DRAINS/OVERFLOW DRAINS
X
66.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
$6.00
=
A.
I, ...,, • ---
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
$8.00
-
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
/
0 CASH 0 CHECK Q VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
it A -Y)--
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: