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2006, 10-20 Permit App: 06004217 Plumbing Fixtures
Permit Center S 6Ra- pe 11707 E Sprague Ave, Suite 106 Valley Spokane Valley, WA 99206•, .. _ PERMIT NUMBER: `f Z (509)688-0036 FAX: (509)688-0037 PERMIT FEE: z Community Development www.snokanevallev.org Plumbing Permit application ❑ Commercial XL Residential SITE ADDRESS: .3 �7 91 (V. 9 t -l- /; D Buildii Owner Phone: �� -�5 g(� Fax: Name: L:rND,4 /Y n cy Address: 3.5'3- A4 S44-4City: (� State: w� Zip: Contractor . Name: lt/p,�l �/UtANS P�U�SyCS Phone S09) A76 -992):S- Fax: Address: a�-� � p�G%r/N RQ City: r,a10,12 Stater Zip: cno6 License No: ffp LE 1 0�0 6 S• City Business Lie: t t Contac = i" Name: Phone: DESCRIPTION OF WORK # OFUNITSX COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 2 URINALS X $6.00 = 3 TUBS X $6.00 - 4 SHOWERS PER TRAP BATH, STALL, ON-SITE BUILT X 1 $6.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT , X $6.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 - �• OD 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 1 $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 1 $6.00 = 19 MEDICAL GAS(per outlet NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 - 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: []CASH ❑ CHECK ❑ VISA ❑ MC EXPIRES: Card# VIN: SUBTOTAL >Cd'� PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05