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2007, 07-27 Permit App: 07002925 Plumbing FixturesPermit Center 11 117003 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www. spokaneval I ev.org Community Development Plumbing Permit Application ❑ Commercial SITE ADDRESS: ^_ L JSQs PERMIT NUMBER: Z_ 95 - PERMIT FEE: Residential Building Owner Name: Phone: Fax: Address: City. State: Zip: Contractor / Name: lit 044 � � It Y1� �.A1 ✓IQ. Phone5b7 Fax ,��'� • City: Spb Qom, State: p !� — 65_ 4i Zip: 97 Address: gG2 a License No c K YLa l jq y/ p5 City Business Lic lv 6:. e ` 9- os -G Contact/ 1/ Name: /G1t7 Li / Phone: s-6 q ^ 73 23 11 1 DESCRIPTION OF WORK TOILETS # OF UNITS X COST T 2 URINALS WATER CLOSET, BIDETS 3 TUBS x x X $6.00 $6.00 $6.00 4 SHOWERS (PER TRAP) 5 SINKS 6 DISHWASHER 7 CLOTHES WASHER 6 9 10 11 12 BATH, STALL, ON-SITE BUILT X $6.00 LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 3 x 86.00 $6.00 $6.00 GARBAGE DISPOSAL WATER SOFTENER $6.00 $6.00 ELECTRIC HOT WATER TANK FLOOR DRAINS NOTE: IF GAS, SEE MECHANICAL AREA, CASE, COIL, TRENCH, CONDENSATE $6.00 $6,00 ROOF DRAINS/OVERFLOW DRAINS $8.00 13 14 15 16 FOUNTAINS, DRINKING WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL SEWAGE EJECTOR $8.00 NSTALLATION, ALTERATION, REPAIR, REVERSALS $6,00 WATER USING DEVICE GRINDER, SUMP PUMP ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER $6.00 $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 19 MEDICAL GAS (per outlet) 20 MISCELLANEOUS PLUMBING FIXTURE NITROUS OXYGEN 21 PRIVATE SEWAGE DISPOSALISYS x x X X 86.00 86.00 $6.00 $20.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# AIJTHORIZED SIGNATURE: REVISED 8126/03 EXPIRES: • VIN: SUBTOTAL 4 D- 06 PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: 9s. oo