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2006, 03-10 Permit App: 06000779 Plumbing FixturesPermit Center S �ute 11707 E Sprague Ave, Suite 106 �///+ , .e iY , t1 le, . Spokane Valley, WA 99206 " (509)688-0036 FAX: (509)688-0037 Community Development spokanevallev ori: Plumbing Permit Application SITE ADDRESS: PERMIT NUMBER: CM PERMIT FEE: n Commercial Ecc Residential 9(2& S- Rccs Building Owner Name: Phone: Ca z y _ Fax'. Address: Z O -Z n/ $ i) ) Lia r) City:s K00.c. Ya I I<>' State: 1/1/4 Zip' 99 Z/6 Contractor I]O Name: �GGS e c vt �s�G Phone: 9-t 6— 79So Fax 9Z(o- C'2 7 I)i Address: 1'"-t_Z L 0 " F . TL Or-lp ( 1C d City: S(�,,,,,, �2 State: j/l�jQ zip 9c z 06 License No: Ci a.5 t LT ti 7 r7 City Business Lic 0 Z—%C7 L Contact xCnI/i✓l—NoAcs Phone:ZG ���Name: r DESCRIPTION OF WORK # OF UNITS X COST TOTAL AMOUNT TOILETS WATER CLOSET, BIDETS X $6 00 2 URINALS X $6.00 3 TUBS X $6.00 4 5 SHOWERS (PER TRAP) SINKS BATH, STALL, ON-SITE BUILT X $6.00 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 X $6.00 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 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 56 00 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P. B. P. D. FOR: VATS, TANKS, BOILERS i X $6.00 , oo 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 DISPOSAL/SYS X $20.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: ❑CASH 0 CHECK ❑ VISA 0 MC EXPIRES: Card# VIN'. AUTHORIZED SIGNATURE: REVISED 8/26/05 SUBTOTAL o0 PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: I/, 00