2004, 10-05 Permit App: BLD-04-07855 Plumbing Fixtures*lane
400/Valley
Project Address:
Owner: 7f! C I/-I`t I ,�-171
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PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use:
Phone (Daytime Contact):
Mailing Address:
Zip Code
Contractor. C . D tAv—e., c
Mailing Address: leftf8 F=
License #:
City
State
Phone #:
City
State
Zip Code
2
3
4
5
7
8
9
10
11
12
13
14
15
16
17
1
DESCRIPTION OF WORK
*OF
UNITS
X
C •
v
TOTAL
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
(AMOUNT
CO --UO
URINALS
\
X
$6.00
=
TUBS
X
=
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
X
$6.002
=
ID - () 6
SINKS
LAW/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD.
PREP/CULINARY/MEAT
X
16.00
=
DSSI^!WASHER
X
16.00
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL.
X
$6.00
WATER SOFTENER
X
16.00
=
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$6.00
=
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,.
CONDENSATE
X
$6.00
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
FOUNTAINS, DRINKINGX
$6.00
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION. ALTERATION,
REPAIR, REVERSALS
X
X
X
$6.00
56.00
=
=
VA
V
SEWAGE EJECTOR
GRINDER, SUMP PUMP
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
$6.00
=
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK ' '•
VALVE, ANDRP.B.P.D. FOFr
VATS, TANKS, BOILERS
X
$6.00
=
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$'6.00
9 MEDICAL GAS iper outlet)
NITROUS, OXYGEN
16.00
20 MISCELLANEOUS PLUMBING FIXTURE
METHOD OF PAYMENT:
CASH 0 CHECK
DATE:
BANKCARD NUMBER:
Q VISA Q MASTERCARD
EXPIRES:
AUTHORIZED SIGNATURE:
e
X ' 56.00
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: