2008, 08-19 Permit App: 08003229 Plumbing Fixturesfitikane
SaossgUalley
Penult Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX (509)688-0037
Community Development permucenten0?spokanevallel.ore
Plumbing Permit Application
n Commercial U Residential
PERMIT NUMBER
-3zz9
PERMIT FEE:
SITE ADDRESS: 10 52(0 E - yV LLSSICm Sp0Vor Ua-L
Building Owner 01 (._ � W p' f e (
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Name S((( We v1- i, 1
Phonel �'j,Fi),Z(�'(IL-Q Fax
Address �-5af- "2-7-6-0
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Zip:
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Contractor'
Com.
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Name
Phone:
Fax:
Address:
City
State:
Zip
License No:
City Business Lie:
Contact
Name:
Phone:
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
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
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
$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
$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
$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:
❑CASH D CHECK D VISA DMC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES
VIN
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: