2008, 07-28 Permit App: 08002914 Water Piping•
Permit Center
5,--„r. 11703 E Sprague Ave, Suite B-3
iam
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
♦0.1�ey www.sookanevallev.org
Community Development
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
n Commercial ❑ Residential
SITE ADDRESS: 7�r/O5 r 1� SM,
Building Owner
Name: T /2 c,
Phone:
Fax:
Address: — /
,5�ine"
City lIi' 6Nisi
MV� , /0/47
State: „JAI
Zip:
Contractor
Name: TLC CONSTRUCTION
Phone: 509-456-3687
Fax:
Address: 9006 S. HAYFORD RD.
City: CHENEY
State: WA
Zip: 99006
License No: TLCCO••107M6
City Business Lic: 601263777
Contact
-
Name: TERRY COURCI-IAINE
Phone: 509-456-3687
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2
3
4
5
DESCRIPTION OF WORK
TOILETS
# OF UNITS X
COST
TOTAL AMOUNT
WATER CLOSET, BIDETS
X
$6.00
URINALS
TUBS
x
$6.00
X
$6.00
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
X
$6.00
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
6
7
8
9
10
11
DISHWASHER
X
$6.00
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL
WATER SOFTENER
X
56.00
X
$6.00
ELECTRIC HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS, SEE MECHANICAL
x
$6.00
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
13
14
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
FOUNTAINS, DRINKING
X
$8.00
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
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
56.00
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
86.00
21
PRIVATE SEWAGE DISPOSAVSYS
x
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
EXPIRES:
VN:
SUBTOTAL
PROCESSING FEE
S35.00
TOTAL. PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05