2008, 10-22 Permit App: 08004201 Plumbing FixturesiTY,Yi_ 1
�,,f Valley
Community Development
Plumbing Permit Application n Commercial
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permi tcen ter(iL),spokane va l ley. org
PERMIT NUMBER: L.) 2C 1
PERMIT FEE:
® Residential
SITE ADDRESS:
► .3"12 I 2z3 ?� cT
Building Owner
Name:
m ('r1-�L tuna,/ V-tt�Phone: taceN qz 4_2) 1 9 Fax:
Address: i 3 71 / 1? a—t) Cr' City: S P0 411-1Vi V ALC.CY State: L4..) Ft
Zip:tr 9 2, 6
Contractor
Name: F12, 5'T O N E e+�uY,n 0i N G= Phone: Fax:
I n
Address: 5 5 2 S E p I 0-)4( N» a >v LN City: 'C OL -13 (..r State: W (4
Zip:q QOD 5
License No: F 2pr q 6.7 0 I City Business Lic:
`7
Contact . R- S O K
Name: Phone:
r --
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
x
$6.00
2
URINALS
X
$6.00
3
TUBS
1
X
$6.00
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, PREP/CULINARY MEAT
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 DISPOSAL/SYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH 9KCHECK ❑ VISA ❑ MC
Card#
EXPIRES:
VIN:
AUTHORIZED SIGNATURE: a4440-611',614'/A'VI.CZM
REVISED 8/26/05
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: