2006, 07-14 Permit App: 06002725 Plumbing FixturesPermit Center
Sp9lane 11707 E Sprague Ave, Suite 106
'g, Valley Spokane Valley, WA 99206
® (509)688-0036 FAX: (509)688-0037
Community Development wew.spokanevallev.ore
• Plumbing Permit Application n Commercial
0
PERMIT NUMBER: a 733
PERMIT FEE:
Residential
SITE ADDRESS:
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Building Owner
J /%
Name: rta: fp�. ' // Phone: 7 y q 7 Fax:
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v?..// ,J City: State:Zip:
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CoAddress:
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Contractor / 2
Name: ' Phone: Fax:
Address: pC1,c,.. 3 t' City: State:. Eva_ Zip: q 9aa,s
License No: City Business Lic:
-Contact >,[ • i"' _.;arc .f: Y ,. u i
Name: T Rg Phone: I..! h
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DESCRIPTION OF W.6RK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
'
X
$6.00
=
b
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
/
X
$6.00
=
6
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 HOT WATER TANK
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
56.00
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
56.00
=•
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:
SUBTOTAL
[CASH ❑ CHECK 0 VISA ❑ MC EXPIRES:
PROCESSING FEE
535.00
Card# VIN:
TOTAL PERMIT FEE DUE:
7 /
AUTHORIZED SIGNATURE:
REVISED 8/26/05