2005, 05-05 Permit App: 05001449 Sprinkler ValvePLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAA; 4509) 688-0037
For Inspections, CaII (509) 688-0054
Project Address: IOh)q C' /014,47Owner. g C-1IARA .6 rs}e5
Mailing Address: / og19 E • wtA/a
Contractor:
Community Development Department
Building Division
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Permit Use:
nn Phone (Daytime Contact): 9 tel. _t 6 6 6
c>0€1k4ao- unite f 994o6
City State Zip Code
License #: Phone #:
Mailing Address:
Zip Code
City.
State
• BANKCARD NUMBER:
AUTHORIZED SIGNATURE: `\
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
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
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
$6.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
' NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$600
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE •
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONAT ER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE
AND R.P.B.P.D. FORY‘VAJS, TANK ILERS
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 DISPOSAL/SYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
0 CASH CHECK
DATE: S ' V 5 '
0 VISA ❑ MASTERCARD
SUBTOTAL
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
' L/ /' 0 0
• BANKCARD NUMBER:
AUTHORIZED SIGNATURE: `\