2007, 05-16 Permit App: 07001812 Plumbing Reversal, FixturesPermit Center
*Wane 11707 E Sprague Ave, Suite 106
Valley Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
Community Development WWW spokanevallev.ore
Plumbing Permit Application
PERMIT NUMBER: ) czb1�
PERMIT FEE:
❑ Commercial ❑ Residential
41
SITE ADDRESS: ' 3 D 18 f
Building Ownet�h. IQ�°�
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Name:
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Phone:
Fax:
Address:
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State:
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DESCRIPTION OF WORK
# OF UNITS X
COST
TOTAL AMOUNT
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
56.00
6
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6 00
9
WATER SOFTENER
X
$6 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
$6 00
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR.
REVERSALS
X
$6.00
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
$6.00
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
520.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH D CHECK D VISA DMC
Card#
AUTHORIZED SIGNATUREH..
REVISED 8/26/05
EXPIRES.
VIN:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE: