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2008, 04-14 Permit App: 08001380 Plumbing FixturesSpokane Permit Center 1 1170703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 valley. (509)688-0036 FAX: (509)688-0037 4000 www. spokaneval ley. ore Community Development Plumbing Permit Application ❑ Commercial PERMIT NUMBER: /SZ,V PERMIT FEE: esidential SITE ADDRESS: 7r— �� / e ci Building Owner Name: / / 7 9/c4.. f4%%¢ Phone: Fax: /7j` j 0 jc� y Address: /l S ,.� f Jr�/ e, N. v / `) S f_ T City: -�©A�� State: �74 Zip: ?��� ,` / Contractor ` Name: TLC CONSTRUCTION Phone: 509-456-3687 Fax: Address: 9006 S. HAYFORD RD. City: CHENEY State: WA Zip: 99006 License No: TLCCO** 107M6 City Business Lic: 601263777 Contact Name: TERRY COURCHAINE Phone: 509-456-3687 1 2 3 4 5 DESCRIPTION OF WORK TOILETS # OF UNITS COST TOTAL AMOUNT WATER CLOSET, BIDETS X $6.00 URINALS TUBS X $6.00 X $6.00 SHOWERS (PER TRAP) SINKS BATH, STALL, ON-SITE BUILT X $6.00 LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X $6.00 6 7 8 9 DISHWASHER X $6.00 10 11 CLOTHES WASHER x $6.00 6, co GARBAGE DISPOSAL WATER SOFTENER X $6.00 X $6.00 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 14 FOUNTAINS, DRINKING X $6.00 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS i 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 20 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 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 ❑ CHECK ❑ VISA ❑ MC /Card# EXPIRES: VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: -aEVISED 8/26/05