2007, 12-31 Permit App: 07004994 Plumbing Fixtures.00.0 Valley
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. spokaneval l ey. org
Plumbing Permit Application n Commercial
PERMIT NUMBER: 49q(-1
PERMIT FEE:
Residential
3
SITE ADDRESS: ` Z 5 °
Rei K
Building Owner Da. yin E. 4_,
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Name: �Q \ f L.et Bele 0.�
Phone: ((js'
`t 34-�
Fax:
Address: i i 2s. v. ?,,A(.....t
City: 5-poK4-ti(l.�
State: (�l/
qQ
Zip: 1 Z Z
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Contractor 1n i C h G e 1cal, T ev l✓1 t'
Name:
Irl j c_l k. V ?oI. Irev 1,n +
Phone: c 2e- 26 f 5
Fax:
Address: 1 1 N) t% E, 2 6 +h Oni,e
9
City: Sp `7vk�'�+p V 41 �?
State: (� f
zip: q Gl7C� i7
License No: P o i'T' /174 Z 6 l
City Business Lic: D t
ttt"`JJ1
'ZOO 669
Contact
Name: Ft' I J+et j V
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Phone: I � C l S
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DESCRIPTION OF WORK
# OF UNITS
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
(;, 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
$6.00
,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
, o0
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
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
X
$6.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
/ASH El CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
EXPIRES:
VIN:
SUBTOTAL
8.00
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
53 , Oo
Effective October 28, 2007
P:\Community Development\Forms\Building forms\Plumbing Permit Application.doc