2007, 01-18 Permit App: 07000167 Plumbing Fixturesk
Spokane
,=Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokan evallev.ore
Plumbing Permit Application n Commercial
SITE ADDRESS:
_Stip% / / e
PERMIT NUMBER:
PERMIT FEE:
Residential
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Building Owner
Name:
Phone: Fax:
Address: 15, till 1, J 4. /4
Ake City: State: Zip:
Contractor
Name: „/ p�vM� /n b
Phone: („t)) -7�' I L/-� 5 % w 7 Fax: p 77t�lf
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Address: / ] / , fc L.
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City: s Al /C ``i e State: ei J Z 7 Zip:
License No: C C l L A 0
PL Wil 02250City Business Lic:
Contact
Name: ,..:Ti/J-7/i- h -6e z tJ
Phone: i ,J T f 9 ) 5`7
DESCRIPTION OF WORK
# OF UNITS X
COST
TOTAL AMOUNT
1
2
TOILETS
WATER CLOSET, BIDETS
x
$6.00
URINALS
3
4
TUBS
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X
$6.00
X
$6.00
X
$6.00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD; PREP/CULINARY MEAT
X
$6.00
, &o
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
$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
20
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
❑CASH 0 CHECK 0 VISA 0 MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:0 0 ->