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2008, 03-04 Permit App: 08000699 Water Heater
�'sy llry Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Plumbing Permit Application PERMIT NUMBER: 1' - -�{ `II PERMIT FEE: n Commercial ❑ Residential SITE ADDRESS: Building Owner J �yJ' egC v Name: ...5Z-7( A,( e, Phone: 2©fi?r,.4.�- , Fax: Address: 1 2Z . ,� ,, fie �� City ÷!/ State: Zip: Q 63 Contractor 7 r u �D>-s9-0-��Q Name: /2.e.4.4,s4—‘2--4---- Phone: Fax: Address: 6 77c, I - City:Gly p State: Zip: 37„," License No:City Business Lic: Contact Name: ri Phone: 205 F�r o 0 7 Tn DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 2 URINALS X $6.00 3 TUBS X $6.00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $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 8 GARBAGE DISPOSAL X $6.00 9 WATER SOFTENER X $6.00 10 ELECTRIC WATER HEATER 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 $6.00 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $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 Card# AUTHORIZED SIGNATURE: EXPIRES: VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: / qT7 Effective October 28, 2007 P:\Community Development\Forms\Building forms\Plumbing Permit Application.doc