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2005, 05-23 Permit App: 05001734 Plumbing Fixtures, ROWAnticipated start date ROW CONSTRUCTION PERMIT CJS 12 3`1 DEPARTMENT OF PUB[ -IC WORKS Permit # PW Location of property Applicant Name �'-- Phone Address -% 6/414-Z- .�. .. • ' Contractor's Name • ... _� 9�� Address cotes No.EINASZE202B12339A (Provide site swat or pipe esnecessary for chatty) 1:1 Sewer Connection G� � Grub & �' Sidewalk �ar�s�t,�iioo Caber Roth.r Pavement Gut? Dimensions beanswits t • .Bo d f /Parcel #, if available) �s cf tiolder Dam tnit___.. Fees Paid;(Application) (inspection)• $10.00 or $25.00, insosoilon on each ttwglbe In to the Pe � .� hour t $25.00 ('1 Pem ittee baled to e � en �to these terms • signature � p Date Work completed godly (3f9 W,a{R,,.Nnn TOW. mitered ban THOD 0 CASH TE: crr�' cx Spiokane ii••••sValley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 • PROJECT ADDRESS: :c0 9 6: >2*. . I MAILING ADDRESS: OWNER PERMIT USE: PHONE (Daytime Contact): 9 6., pp - (street) (city/state) (ZIP) CONTRACTOR: i / _ / _ C / hs_t_n_cti .0)\) MAILING ADDRESS: LICENSE #: Hs s C o J -4( 13 k r PHONE #: q ki lS Z�10 11817 g ()ctley °° 4)(z__ q6 (street) (city/state) (GIP) PLUMBING FIXTURES EXPIRES: VKCARD NUMBER: THORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNTTS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS / X $6 - ‘ PO 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 5 SINKS LAVS/BASINS, BAR, FLOOR KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X $6 - 6 DISHWASHER X $6 - 7 CLOTHES WASHER X $6 •- 8 8 GARBAGE DISPOSAL X $6 - 9 WATER SOT- 1 t•NER X $6 - 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6 - 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING. REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFED, CARBONATOR, SWAMP COOLER X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS x $b - 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK mom �...W' __ ._ .-- : SUBTOTAL:OC 6, .~ PLUS PROCESSING FEE: $35.00 ■ Mffilnia ■ TOTAL PERMIT FEE DUE: en, !J/ EXPIRES: VKCARD NUMBER: THORIZED SIGNATURE: