2015, 06-01 Permit App: BLD-2015-1252 Plumbing FixturesPermit Center
I Project #0147-6
-Wane 11707 E Sprague Ave, Suite 06 RECEIVED
Dalley Spokane Valley, WA 99206
(509)688-0036 FAX: (509 8-0037
Community Development www.sookanevallev.orz.conl
Plumbing Permit Application 1 o Commercial %Residential
JUN 0 1 2015
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Phone: Fax
B OF UNITS
Address:
City State
Zip
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Name: &Old Seg 1 071.br
Phone: S6et-Sas-59Y6 Fax:
$8.00
Address:
City State
Zip
License No:
City Business License No:
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Name:
Phone:
AUTHORIZED SIGNATURE:
REVISED8/2695
DESCRIPTION OF WORK
-
B OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
- WATER CLOSET, BIDETS
Z
X
$8.00
=
_
i 2-
2
URINALS
X
$6.00
=
_
3
TUBS
Z
X
$8.00
=
/2
4
SHOWERS _TER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
I.AVSBASINS, BAR, FLOOR KITCHEN,
LAUNDRY. UTIUTY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
Z
J
X
$8.00
=
—
i
6
DISHWASHER
1
X
$8.00
=
6
7
CLOTHES WASHER
I
X
$8.00
=el
8
GARBAGE DISPOSAL
X
$6.00
='
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$6.011
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
. =
13
FOUNTAINS, DRINKING
-
X
$8.00
=
14
WATER PIPING/DRAIN4N WASTE.
VENT PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$8.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP ..
X
$8.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER^
PROOFER, CARBONATOR SWAMP COOLER
L
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
$8.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS_
X
$20.00
-.
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
DATE:
SUBTOTAL
66
0 VISA 0 MASTERCARD
PROCESSING FEE
$3500
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED8/2695