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2008, 02-28 Permit App: 08000629 Plumbing Fixtures
• Sidiane ' .,,0 Valley Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Plumbing Permit Application n Commercial PERMIT NUMBER: O, (.0Q PERMIT FEE: ©Ztesidential SITE ADDRESS: /9.32 Y £ &ciy e U//y. ziy,PF$127 Building Owner Name:pkv 7 ,e, - -e,- Phone: Fax: �2 -l6" 3 Z Address: / < 0 r F , Be4 c / City:--S'j�a.,t..._ t / State: 4/4 Zip:270 7 Contractor . •tel � Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name:4/rBfV /� �(-t(2 a- Phone: Lei_..3 y Z _ /--,.3 Z DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS l X $6.00 (0 - 2 URINALS X $6.00 3 TUBS X $6.00 4 SHOWERS (PER TRAP) /✓b BATH, STALL, ON-SITE BUILT X $6.00 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT l X $6.00 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 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 ❑ CHECK Ird'VISA ❑ MC Card# AUTHORIZED SIGNATURE: EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: 5 3 Effective October 28, 2007 P:\Community Development\Forms\Building forms\Plumbing Permit Application.doc 47: :SEWAGE -S,Y.,,T0.111 • , .4. -11.i licautehio; 013.;•973i.: , ea Tract:ail DiitettAiiiliCatfontL 01/14/2008 - - ' 324,456T inspection Announcement: 324-1581 Lot/Block/Subdivison S082.0146 L B SP -93-878 TR"B" . _ 4,i.StRnj ainny.,4ev nen Property Size: ! Owner Phone: (509) 892-4102 No of Bedrooms Additional bedrooms will require a larger system '41544-eaPbSed?IgSOptic Tank 1000 ter-SYStOni: Property Located In: / zet$Addt-Biiilding'Seiniet - ' Public sewer svc area? No , .19324 E BUCKEYE ROAD SPOKANE WA 99207 • - „-, - _ ,,,,:',':*:, iivimuMspga4,,,°FitAri9pp REQUIRED :;.'--, FlovVrateC,' =-'-'-- ---' gal/day :-..--=:''' dosage vol ' gal/cycle TR E,t.TINZNTFkCILITY: -- !_ =:!:. DISPOSAL FACIUTY: • . .., ' ,0 Drainfieid size: Flow rate/(Soil loading rate gals/sq ft X i .0 -Sand Filter 0 Other: agellaintenance,A" em_.„. ttreqoirpIcp:II:= =NO =-0 No - .- , : -"-:".. SegreOption Date: Easernent required: 0 Yes • 0 No _ _. Easement Reed date - IVRMISR9M.Y.Ty4-14D;WHPI;Flig APPROPRIATE SIGNATURE IS ENTEREIXUNPER:"APPLICATION APPROVAL" and -=-:-- ., :. -.:. - A -Nb 4200f -,Agency ApOrgyal/Dae.- - - Budding DepartMette1eaSe Date " '‘Initials --`„ HEALTH OFFICER REPRESENTATIVE APPROVAL Operational Peiini Approved by Approval - - 90 I-' / 5.$