2015, 06-01 Permit App: BLD-2015-1246 Plumbing FixturesPermit Center ( Project #
okan` 11707 E Sprague Ave, Suite 106 RECEIVED
Valley Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www.snokanevallev.ora.c t
Plumbing Permit Application o Commerlcial� 1g
}Residential
SITE ADDRESS 1071, NL AY" tfe5 I Lin CSV PERMIT CENTER
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Name: %LOC, It CptiS
Lddress:
lx
City
Jame: [-d
SQA.
Fax
State
Zip
Phone: SO4 - S 39 - $ Q fl6, Fax:
address:
City
State
icense No:
7716`. Lt1.tt...st n,«ctSitcg
City Business license No:
Zip
lame:
Phone:
JTHORIZED SIGNATURE:
REVISED S116/05
1
DESCRIPTION OF WORK
-
0 OF UNITS
X
COST
=
- TOTAL AMOUNT_
1
TOILETS
WATER CLOSET, BIDETS
Z
X
-$6.00
=
12-
2
URINALS
X
$6.00
=
3
TUBS
Z
X
$6.00
=
12
4
SHOWERS_(PER TRAP)
BATH, STALL, ONSITE BUILT
X
_
$6.00
=
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LITY, JANITOR, PHOTO.
X-RAY, FOODIPPREP/CULINARY MEAT
3
X
56.00
=
/A
3
DISHWASHER "
(
X
56.00
=
4
I
CLOTHES WASHER
(
X
56.00
=
6
3
GARBAGE DISPOSAL
X
$6.00
=
3
WATER SOFTENER
-
X
56.00
=
0
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
1
FLOOR GRAINS
AREA, CASE, COIL TRENCH, CONDENSATE
X
56.00
4.
2
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
. _
3
FOUNTAINS DRINKING
-
X
$6.00
=
I
WATER PIPING/DRAW4N WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR
REVERSALS
1
X
$6.00
=
5
SEWAGE EJECTOR
GRINDER, SUMP PUMP ..
X
56.00
=
3
WATER USING DEVICE
ICE AN/OR COFFEE MAKER HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
--7
`
X
$6.00
=
---
( Z
'
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK VALVE,
AND RP.B.P.D. FOR VATS, TANKS. BOILERS
X
56.00
=
1
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
—
1
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
1
MISCELLANEOUS PLUMBING
FIXTURE
-
X
56.00
=
PRIVATE SEWAGE DISPOSAL/SYS
X
520.00
=
'
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
DATE
SUBTOTAL
6 v
0 VISA 0 MASTERCARD
PROCESSING FEE
535.00
EXPIRES:
TOTAL PERMIT FEE DUE:
JTHORIZED SIGNATURE:
REVISED S116/05
1