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2006, 11-06 Permit App: 06004418 Plumbing Reversal, Fixtures
Permit Center Spokane 11707 E Sprague Ave, Suite 106 .000,005Ualley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development www spnkanevallev.ork Plumbing Permit Application ❑ Commercial PERMIT NUMBER: LI` - rift I Residential PERMIT FEE: 60 SITE ADDRESS: /r71,7? Building Owner - - ... Name: %v/..1/ r.6:7_t!'7 7297e. j. Phone: Fax: Address: City: State: Zip: Contractor . -- .... - .. TSG �',��-5:��.� ,b.L. Name: T' f� y �mcy,'` , Phone: vs� ,_ ?� 7. Fax: !-� Address: 00 c Ci State: % %a„.l ed tY e.6nicY Gv� Zip:?Fe, 07 License No. 7-2 C CO ' /n7 1-• City Business Ltc ',Contactis/ Y' Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS - / X $6.00 = (p cm 0 .2 URINALS - X $6.00 = 3 TUBS / X - $6.00 = 6c 0 Q 4 SHOWERS (PER TRAP) BATH. STALL, ON-SITE BUILT / X $6.00 = 6 r 0 0 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY. UTILITY, JANITOR, PHOTO, X-RAY, FOOD; PREP/CULINARY MEAT / X $6.00 = � 6' t 0 (� 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 $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: ❑CASH U CHECK U VISA 0 MC EXPIRES: Card# VIN: SUBTOTAL c/ PROCESSING FEE 535.00 TOTAL PERMIT FEE DUE: 'c5 9', 00 AUTHORIZED SIGNATURE: x REVISED t/16/05