2010, 07-09 Permit App: 10002049 Plumbing FixturesS�kanne
ey
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevall e v.ora
PERMIT NUMBER: ?.r
PERMIT FEE:
Community Development
Plumbing Permit Application [] Commercial esidential
it
1 01 C- P- L4S ne_ S,/t1 t/G ((/ Gy
SITE ADDRESS:
1
2
3
4
5
DESCRIPTION OF WORK
TOILETS
# OF UNITS
X
COST
TOTAL AMOUNT
WATER CLOSET, BIDETS
X
$6.00
URINALS
TUBS
X
$6.00
X
$6.00
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
7
8
9
10
11
DISI-1WASHER
X
$6.00
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL
WATER SOFTENER
X
$6.00
X
$6.00
ELECTRIC WATER HEATER
FLOOR DRAINS
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
13
14
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
FOUNTAINS, DRINKING
X
$6.00
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:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
Building Owner
Name: '11 dol
(16c
1/'-
Phone: 7 _
92
I ci
Fax:
r4n
Address: _1 (J�`j s
'
L
City: Sr0 14 4,..e
v
((„
km State:
��
Zip:
1'0/-7
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
Phone:
1
2
3
4
5
DESCRIPTION OF WORK
TOILETS
# OF UNITS
X
COST
TOTAL AMOUNT
WATER CLOSET, BIDETS
X
$6.00
URINALS
TUBS
X
$6.00
X
$6.00
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
7
8
9
10
11
DISI-1WASHER
X
$6.00
CLOTHES WASHER
X
$6.00
GARBAGE DISPOSAL
WATER SOFTENER
X
$6.00
X
$6.00
ELECTRIC WATER HEATER
FLOOR DRAINS
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
13
14
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
FOUNTAINS, DRINKING
X
$6.00
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:
❑CASH ❑ CHECK ❑ VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: