2008, 11-10 Permit App: 08004441 Cross Connect DeviceRECEIVED 11/07/2008 10:51 5096880037 SV PERMIT CENTERFR
11/07/2008 10:49 5094824310 C&C YARD CARE
San"
..0Valley.
Community Development
Permit Center
11703 E Sprague Avc, Suite B-3
Spokane Valley, WA 99206
(509)6A80.036 FAX (509)688-0037
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Plumbing Permit Application
PAGE 03/04
❑ Commercial 3 Residential
SITE ADDRESS: _1—
I IEl I5) L. II V'' v
Building Owner
I 1/4-11lt
Nmnc. N/(,Uely YL \Aiw`aI�
Phone. Fax:
zip.
nddms: 11dIS1r. MartcA-kA_
City: It
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Contractorr
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Name:C , ITQ4 eon
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Phone' 2./8a _O�'� FOX: [I'/gsa' 7JIU
Addre,,: Env is,ii, 8
City'6,olre,m State. We. Zip 9Q2-,2
CityBuainessLie
License No: q^
rc‘rctt'n \
4-�
Contact P{
Name: m/Y'k_
Pnone: of-T`pct J.?
2
3
4
5
DESCRIPTION OF WORK
TOILETS
URINALS
TUBS
POF UNITS X COST a TOTAL AMOUNT
WATER CLOSET, BIDETS
90.00
x
36,00
X
30 00
SHOWERS (PER TRAP)
SINKS
BATH STALL ON-SITE BUILT
58.00
LAVSIBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY FOOD, PREP/CULINARY MEAT
x
39.00
0
7
8
9
10
11
DISHWASHER
x
$8,00
CLOTHES WASHER
x
66.70
GARBAGE DISPOSAL
WATER SOFTENER
X
76.00
X
36.00
ELECTRIC HOT WATER TANK
FLOOR DRAINS
NOTE: IF GAS SEE MECHANICAL
AREA, CASE. COIL, TRENCH.
CONDENSATE
x
5600
X
56 00
12
13
14
15
16
ROOF DRAINS/OVERFLOW DRAINS
FOUNTAINS, DRINKING
X 3600
X
3000
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
SEWAGE EJECTOR
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
S600
GRINDER SUMP PUMP
X
36 00
WATER USING DEVICE
ICE AN/OR COFFEE MAKER. HOSE EIB,
STEAMER
PROOFBR. CARBONATOR, SWAMP
COOLER
X
56 00
17
18
19
20
21
22
CROSS CONNECTION DEVICE
INTERCEPTORS
VACUUM BREAKER, ;HECK VALVE,
AND R.RB P C FOR: VATS, TANKS,
BOILERS
35.00
I Let
GREASE TRAP. SAND TRAP,
CHEMICAL HOLDING TANK
36,00
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
36,00
MISCELLANEOUS PLUMBING FIXTURE
PRIVATE SEWAGE OISPDSAUSYS
X 36 CO
320.00
INDUSTRIAL WASTE INTERCEPTOR
X 315.00 =
METHOD OF PAYMENT;
OCASH ❑ CHECK ❑ VISA Ip MC
Cardd
AUTHORIZED SIGNATURE:
REVISED titWO1
'sir
d„A/iIrt -
EXPIRES:
VIN.
SUBTOTAL
(Do
PROCESS NG FEE
TOTAL PERMIT FEB DUE;
335.00
$1-/1,00