2009, 02-27 Permit App: 09000472 Plumbing FixturesPermit Center
e
11703 E Sprague Ave, Suite B-3
` al Spokane Valley, WA 99206
Yd(509)688-0036 FAX: (509)688-0037
Community Development penniteenter@spokanevallev.org
Plumbing Permit Applicationn Commercial
SITE ADDRESS: 2124 E M/e YLE A -
PERMIT NUMBER:
PERMIT FEE:
❑ Residential
Building Owner
Name:
g2.,�, 0/4-1/13
Phone: 95 U_ 6 Y z.
/ 7
Fax:
Address:
(� iZ I � —
City: n
State:
Zip:
Contractor
/
Name:fro
Phone: a S_/ _ 8b !J S
Fax:
Address:
660e ,„ / ,,
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City: 3,Y ��-v4 CaZFS
State:
Zip:
c
/6
License No:
✓1 , ,N'l 10 FYeI 51 / 3 L
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City Business Lic:
Contact
Name:
/! !/ I I W C 022. rl.�
Phone:
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DESCRIPTION
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
$6.00
4
5
SHOWERS (PER TRAP)
SINKS
BATH, STALL, ON-SITE BUILT
X
$6.00
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 WATER HEATER
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
$6.00
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
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
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
ECASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: