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2007, 08-07 Permit App: 07003077 Plumbing Fixturesn Permit Center Spoka`nVye 11707 E Sprague Ave, Suite 106 coo:OFalley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development www snokanevallev ore Plumbing Permit Application ❑ Commercial ❑ Residential PERMIT NUMBER: --`‘.3C7 PERMIT FEE. SITE ADDRESS: :24 Building Owner j r�%$Y��� - -_ Name: Q� r� Phone 72. '7 / Fax Address: e �, �OYI - �C1Ye/✓� ../ City C7 )w,a-- e State �� ji Zip e���Q/ Contractor -//O_- -moo, Name: Phone. Fax: Address. City: Stale' Zip' License No: City Business Gr Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 2 URINALS / 1 $6.00 X 56 00 3 TUBS X $6.00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X 56 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 $6 00 8 GARBAGE DISPOSAL X 56 00 9 WATER SOFTENER X 56.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 56 00 12 ROOF DRAINS/OVERFLOW DRAINS X 56 00 13 FOUNTAINS, DRINKING X 56 00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS X 56 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 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 DISPOSAL/SYS X $20 00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA 0 MC EXPIRES Card# VIN: AUTHORIZED SIGNATURE: REVISED g/26/05 SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: