2007, 10-29 Permit App: 07004332 Water PipingSliblEne 11707E Sprague Ave, Suite 106
ey Spokane Valley, WA 99206
410/0 (509)688-0036 FAX: (509)688-0037
Community Development v;ww,snokanevalley.ore.com
Plumbing Permit Application ,. Olommercial „Residential
SITE ADDRESS: 2-f, / / j : /C� / �C 6� 1,7
PERMIT NUMBER: `t 3 3
PERMIT FEE: 1-/'
Braiding owner . / o 1 J .' Jr / c d,
1 . .
Name: :�G) in, N
Phone: Fax:
COST
/ •)
Address: % >r `1 /� , (jam• i
( �%
City. ?�1 Gli - State: ///,7a/Zip:
Coatracfor . s •
, 9,) /`
TOILETS
/'/
Name: , f 0,)l7 (, '" jY�/ C L((
Phone: y,� — jy y Fax:
X
Address: l/ (r,/ ? Al 64/10.2 i,1,1 /
,y
City : iv .,,, State: %�%r:
ZP9 9`)-d b
License No: it S C'»- - /,I 5/6J Li
City Business License No:
X
56.00
Name:
Phone:
3
AUTHORIZED SIGNATURE:
REVISED 8126105
DESCRIPTION OF WORK
11 OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
56.00
=
3
TUBS
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTIUTY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
56.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
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
56.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING REVERSAL ,
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
56.00
=
‘)..:714
7,n
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS, TANKS, BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.0D
=
19
MEDICAL GAS (per outlet)
NITROUS. OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
56.00
=
21
PRNATE SEWAGE DISPOSAUSYS
X
520.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK
Card#
SUBTOTAL
0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8126105