HomeMy WebLinkAbout2006, 09-29 Permit App: 06003905 ReversalS OI ne
Walley
Community Development ‘,ti.w'wspokanevalley.ore
'Plumbing Permit
%/iApplicfation �} 1-Ptem SITE ADDRESS: .3(9 / / J / , FX, em" -
11707E Sprae e Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
PERMIT NUMBER -- j •
Residential
Building Owneerr
es
Name: r
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Phone:
Phone: e7;::
Fax:
Address: 3cp ICj f
l
City.
State: Zip:
Contractor
Name:
IP• / lS
,
Phone:.3a1,--67.o.51--
Fax: �j 40607
Address:
3 7/j)� - �
'.fes
City: C�,0 1 i
State: Zip:Ql /i 1
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License No:
1`3 l(I LkT
a. S(lI /n i
City Busifiess Lic:
Contact :,•
Contact
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' CAOL-er.11 '" . \ �Z.�
Name:
#(7)Th
Phone: 41) 5-P
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOILETS
WATER CLOSET, BIDETS
X
$6.00
TOTAL AMOUNT
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
SHOWERS (PER TRAP)
BATH, STALL ONSITE BUILT
X
$6.00
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.0D
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
$6.0D
11
FLOOR DRAINS
AREA, CASE, COIL TRENCH,
CONDENSATE
X
$6.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
114
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-N WASTE,
VENT, PLUMBING, REVERSAL
X
$6.00
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
GROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS, TANKS,
BOILERS
X
$6.0D
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.0D
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAVSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED an6los
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: