Loading...
2009, 04-29 Permit App: 09001095 Plumbing Fixtures Permit Center "T'�`� 11703 E Sprague Ave,Suite B-3 SII PERMIT NUMBER: ......*Valley Spokane Valley,WA 99206 (509)688-0036 FAX:(509)688-0037 PERMIT FEE: Community Development wniw.spokanevallev.ore Plumbing Permit Application ❑ Commercial Residential SITE ADDRESS: Building Owner Name: Phone: Fax: Address: City: State: Zip: Contractor n Name Q„ea/ S0/ le/writ /07- . Phone: /..bee, _ /_ 7 Fax: C!C Address:(gc 7 b Q//. 4 C4 1)/�1 1riVi;4i15 State:14,4 Zip:9qc)(94, License No 5pa�e (q36p City Business Lic: Q(:)_ 77„7._ .a./"1 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 X $6.00 = LAYS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT 6 DISHWASHER ( X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL I X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC WATER HEATER NOTE: IF GAS,SEE MECHANICAL X $6.00 = AREA,CASE,COIL,TRENCH, 11 FLOOR DRAINS CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 = 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = ICE AN/OR COFFEE MAKER,HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, AND R.P.B.P.D.FOR: VATS,TANKS, 17 CROSS CONNECTION DEVICE BOILERS X $6.00 = GREASE TRAP,SAND TRAP, 18 INTERCEPTORS 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 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE OCASH ❑CHECK ❑VISA ❑MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05