2006, 06-29 Permit App: 06002536 Plumbing ReversalPermit Center
Sgo"kanne 11707 E Sprague Ave, Suitt 106
Spokane Valley, WA 99206
(509)68S-0036 FAX: (509)68S-0037
Community Development WWW .s-ookanevalley.ora
Plumbing Permit Application ❑ Commercial
airowValley
PERMIT NUMBER 41-6- 3 S-'
PERMIT FEE: 41,1947__
Residential
SITE ADDRESS: T5O S A} -7T-1_,( 4-g-- -7/4 >^fl CAE< ✓a"A/- LL Cy) WI 9P1
Betiding Owner ) 5 o V .' V . C (il 7-Y4- 5, —q77 if- L) 6 / a LKi a t/M
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Name:
( Z• 6 ub4 M G v,t,) P ru,/v Phone: (roe) 2 —79e; Fax:
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Address:
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Contractor
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Name:
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Fa x:
Address:
.7-j 6z'~ AI e L/7/.(46kt CitC 5m 0'KA/r,
State:
LA Jo_
Zip
2/ r: --
License No:
City Business Lic:
Contact ,
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....
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Name:
Phone:
DESCRIPTION OF WORK
II OF UNITS X
COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6.0D
2
URINALS
X
56.00
3
TUBS
X
56.00
4
SHOWERS (PER TRAP)
BATH. STALL, ONSITE BURT
X
56.00
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, REP/CULINARY MEAT
X
56.00
6
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
56.00
6
GARBAGE DISPOSAL
X
56.00
9
WATER SOFTENER
X
56.00
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
56.00
11
FLOOR DRAINS
AREA CASE, COIL, TRENCH,
CONDENSATE
X
56.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
13
FOUNTAINS, DRINKING
X
56.00
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR
REVERSALS
X
56.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
56.00
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
56.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
❑CASH 0 CHECK 0 VISA 0 MC
Card#
AUTHORIZED SIGNATURE:
FE 9SED B26N5
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE: