2006, 03-10 Permit App: 06000779 Plumbing FixturesPermit Center
S �ute 11707 E Sprague Ave, Suite 106
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.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
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Name: �GGS e c vt �s�G
Phone: 9-t 6— 79So Fax 9Z(o- C'2 7
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Address: 1'"-t_Z L 0 " F . TL Or-lp (
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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
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Contact
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Phone:ZG ���Name:
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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