2006, 04-24 Permit App: 06001497 Plumbing FixturesPermit Center
S Ohne 11707 E Sprague Ave, Suite 106
p Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Development w w.sookanevallev ore
Plumbing Permit Application
Ua11ey
in Commercial
PERMIT NUMBER: 14 97
PERMIT FEE:1' 3 „
sidential
SITE ADDRESS:
1/0 3 A/ fi -c-
Building Owner
Name:
hone: a oggr
Fax:
Address: / a %D.al-7.0.g.,2c-�
City: tZta 7 /.?,d
State.
g-(/0.__
Zip:
/
5 ? /tzs'
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact.
- _.
Name: Oa 4 C4/
µ
Phone: 7 2 2. 456 q. r
DESCRIPTION OF WORK
R OF UNITS X
COST =
TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
X
$6.00
oe
2
URINALS
X
$6.00
3
TUBS
X
$6 00
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
l
X
$6 DD
QO
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
l
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 OD
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
16
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:
DCASH D CHECK Eglia DMC
Card,/
AUTHORIZED SIGNATURE:
REVISED 6/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
J'-3, C9'