2004, 05-04 Permit App: BLD-04-04261 Sprinkler System*lane
Malley
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address:.- 1.2-07 Net tA'3<tc9 6LI—Permit Use:
Owner: LLSA P, IA by, ,O . Phone (Daytime Contact):
Mailing Address: E. • Z 207 II-IrA )c u_9
II City State Zip Code
Contractor k4 AA C L9 oS CAC License #: Phone #:
Mailing Address: E , 177072— ' Z C� 2.r) _ S�c r Lb L
City State Zip ode
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
# OF
UNITS
X
COST
n
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
$600
8
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$600
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
INSTALLATION, 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
9
X
$6.00
=
fc IOC
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
=
METHOD OF PAYMENT:
SUBTOTAL
0 CASH CHECK ISA 0 MASTERCARD
PROCESSING FEE
$35.000
y0
DATE: 4 er/6A4 EXPI ES:
TOTAL PERMIT FEE DUE:
471/ • W
BANKCARD NUMBER
AUTHORIZED SIGNATURE: