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2007, 07-19 Permit App: 07002806 Plumbing Fixtures
Permit Center Snn n 11703 13 Sprague Ave, Suite B-3 pOkarie Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 VQ wwwsDokanevallev.org Community Development Plumbing Permit Application —7= 2kO 4n PERMIT NUMBER: PERMIT FEE: i3 n Commercial ® Residential SITE ADDRESS: ZA '5 S-, C-.NCtily Building Owner Name: Phone: — dp_R ax: � Ute, �ltC o� A2�� So / z� 5-� 9 Address. Citiip State:•Zi G 2 ` ` Contractor -- - - - --- _ --. .. -- yV Phone: Fax: Name: cZ p \ Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST = TOTALIAMOUNT 1 . TOILETS WATER CLOSET, BIDETS 3 X $6.00 = \ `Li 2 URINALS X $6.00 = 3 TUBS -S X $6.00 = CCD 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT - S X $6.00 = L) 6 DISHWASHER \ X $6.00 = / lJ 7 CLOTHES WASHER Z X $6.00 = \ Z 8 GARBAGE DISPOSAL \ X $6.00 =cri 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 = LO ,., v 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 81B, STEAMER PROOFER, CARBONATOR, SWAMP COOLER 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 $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: GASH 0 CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05