2006, 03-09 Permit App: 06000743 Plumbing FixturesPermit Center
S O"kane 11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development www,sookanevallev.orc COM
Plumbing Permit Application ❑ Commercial RResidential
PERMIT NUMBER: t07(. b
PERMIT FEE: 53 Ct)
SITE ADDRESS: /5,2
Buid-idg ow�7er-/17K-
rale; i¢ r,,476e7-1.41476e7-1.41
Name: !'1r^!LY047- if
/4747.4" e16N✓1//P.� Phone•. 92 4(1y6
Fax:
Address: /5,-7 .S /-%,F'Az-Q1 Rci City$Ogn✓4 (444 Stale: W/} Zip: (9206'
Contractor . Se ••.....
. �!; -� i ..
Name:
Phone:
Fax:
Address:
City : State:
Zip:
License No:
City Business License No:
URINALS
X
Name:
Phone:
AUTHORIZED SIGNATURE:
REVISED 112675
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
$B.DD
=
4
SHOWERS (PER TRAP)
BATH. STALL, ON-SITE BUILT
I
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 HOT WATER TANK
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
$6.09
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR SWAMP COOLER
X
$8.00
=
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
56.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$2000
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
Card#
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 112675