2008, 11-19 Permit App: 08004567 Toilet, SinkPermit Center
Spokane 11703 E Sprague Ave, Suite B-3
5 ley Spokane Valley, WA 99206
® (509)688-0036 FAX: (509)688-0037
Community Development permitcentcr@spokanevallev org
Plumbing Permit Application [1 Commercial
PERMIT NUMBER:
PERMIT FEE:
I` 1 Residential
SITE ADDRESS:/Ul �V U . / r/� rg re e."-
4.S
�
BuildingOwner
r • c
�M
- -- _
Name Er
sem
s�
, )/
l
Phone: 4Z Z_ xo to
/
Fax:
Address: Cor=T
l
0
C.
I_Jt�
-e -e-i.
City: o,��./�
JTc �4Y
State: �*1
Zi Pn1_ iOJ7
Contractor
//�
-- -- --
Name:
Phone:
Fax
Address:
City'
State:
Zip:
License No:
City Business Lie'
Contact
.
Name.
Phone:
DESCRIPTION OF WORK
# OF UNITS X COST
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6 00
2
URINALS
x
$6 00
3
TUBS
X
56 00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56 00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
56.00
6
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
56_00
8
GARBAGE DISPOSAL
X
56.00
9
WATER SOFTENER
X
56_00
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
X
$6 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
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
56.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6 00
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
❑CASH ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN.
AUfIIORIZED SIGNATURE:
REVISED 8/26/05
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: