2006, 07-07 Permit App: 06002604 PlumbingPermit Center
Sge ne 11707 E Sprague Ave, Suite 106
leY Spokane Valley, WA 99206 PERMIT NUMBER: �2& � l
(509)688-0036 FAX: (5D9)699-0037
Community Development «�;�ti:.�okanevallev.ors PERMIT FEE:��
Plumbing Permit Application ❑ Commercial ['Residential
SITE ADDRESS:
Building Owner ,
DESCRIPTION OF WORK
Name:
w
Phone: Cyd _ �-/ 7 -L
Fax:
Address:
City.
car
State: Z,.44 Zip:Ad
Contractor
WATER CLOSET, BIDETS
Name:
Phone: -ZS Q
Fax:
Address: U S 24
Ctty State:
Gv Zip:
License No:
City Busii1ess Lic:
X
$6.D0
-
Name:
Phone:
NOTE: IF GAS SEE MECHANICAL
7
DESCRIPTION OF WORK
>I OF UNITS
X
COST
-
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
-
2
URINALS
X
$6.D0
-
3
TUBS
NOTE: IF GAS SEE MECHANICAL
X
$6.00
-
4
1 SHOWERS ER TRAP
BATH, STALL, ON-SITE BUILT
X
$6.DD .
-
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
x
¢A nn
=
7
CLOTHES WASHER
X
$6.00
-
8
GARBAGE DISPOSAL '
X
$6.DD
-
9
WATER SOFTENER
X
$6.DD
-
1 D
ELECTRIC HOT WATER TANK
NOTE: IF GAS SEE MECHANICAL
X
$6.00
-
11
FLOOR DRAINS
AREA. CASE, COIL, TRENCH,
CONDENSATE
X
MOD
-
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.OD
-
13
FOUNTAINS, DRINKING
X
$6.00
-
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.DD
-
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 CONNECTIONbEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERSI'
X
$6.DO
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
-
19
MEDICAL GAS r outlet
NITROUS, OXYGEN
X
$5.OD
-
20
MISCELLANEOUS PLUMBING FIXTURE
> �L 1
1
X
$6.00
-
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
-
METHOD OF PAYMENT:
❑CASH ❑ CHECK [D VISA O MC EXPIRES:
Card# VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8!26105