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2008, 01-09 Permit App: 08000091 Plumbing Fixturesl_ Community Development Permit Center 11703 E Sprague Ave, Suite 13-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.org Plumbing Permit Application ❑ Commercial s1TE ADDRESS: cl PERMIT NUMBER: PERMIT FEE: V © Residential Building Owner Name: �.G'.._t. L. i 4. C' I�!�c,.►"1 Phone's', c.l`-iu-Cv,?`-z Fax: C� - z� 3, -/..it LI ,_; city ?,, a,-.� v4tt.z. ` State: �� Zip'c►�1C , Address: _) G `�����i .e `.-1� V - Contractor Contractor Name:Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: t?CLAL1_JiiiC e'er Phone:_ `"��-1—c1' `� _ DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS 1 X $6.00 = 2 URINALS X $8.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT I X $6.00 = 5 SINKS 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 WATER HEATER 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 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: OCASH 0 CHECK 0 VISA 0 MC EXPIRES: Card# VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: _ AUTHORIZED SIGNATURE: REVISED 8/26/05