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2007, 01-19 Permit App: 07000153 Plumbing FixturesSCity 0 pakaliw - Valley Community Development Permit Center 11707 E. Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.org Plumbing Permit Application 1oL PERMIT NUMBER: PERMIT FEE: ( ) Commercial ( ) Residential SITE ADDRESS: 2714 N. Perrine Ct., Spokane Valley, WA 99206 Name: Craig Woodard Phone: Fax: Address: 5003 N Lillian Ct. City: Spokane Valley State: WA Zip: 99216 Name: K. C. Charles, Inc. Address: 5685 Jergens Road City: Nine Mile Falls State: WA Zip: 99026 License No: KCCHAI0880T City Business Lic: 601 219 705 Name Cary E. Berger Phone: 276-1228 DESCRIPTION OF WORK # OF UNITS x COST TOTALAMOUNT 1 TOILETS WATER CLOSETS, BIDETS 2 X $6.00 12.00 2 URINALS X $6.00 3 TUBS X $6.00 4 SHOWERS (per trap) BATH, STALL, ON-SITE BUILT 2 X $6.00 12.00 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 2 X $6.00 12.00 8 GARBAGE DISPOSAL X $6.00 9 WATER SOFTENER X $6.00 10 ELECTRIC HOT WATER TANK 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 X $6.00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6.00 15 SEWAGE EJECTORS GRINDER, SUMP PUMP X $6.00 16 WATER USING DEVICES ICE AND/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 & SAND TRAP, CHEMICAL HOLDING TANK X $6.00 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6.00 20 MISC. PLUMBING FIXTURE X $6.00 21 PRIVATE SEWAGE DISPOSAUSYS X 820.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: ( ) CASH ( ) CHECK ( )VISA ( ) MC CARD# AUTHORIZED SIGNATURE: REVISED 8/26/05 EXPIRES: VIN: SUBTOTAL 36.00 PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: 71.00