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2007, 04-20 Permit App: 07001399 Sewer
Permit Center q 1 3°1, "'" 11707E Sprague Ave,Suite 10(„ Spokane q 1 PERMIT NUMBER: Valley Spokane Valley,WA 99206 (509)688-0036 FAX:(509)688-0037 PERMIT FEE: Community Development www.spokanevallev.ore Plumbing Permit Application ❑ Commercial )Residential SITE ADDRESS: Building Owner Name: 0 Phone: 7 y 7Fax: Address: /y 3 05— , ),),' .'e}v e "9vt. City:5,0/Tem.e if Y //ei State:tv4 Zip:? 0/6 Contractor �,i Name: t2- Phone: Fax: 7"L c oy75 fr X6. 1-,Oct �a 7-6 7�v Address: City: State: Zip: License No: City Business Lic: Contact Name: /n( ` Phone: `1 41/1 (Y- DESCRIPTION OF WORK / #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6.00 = 2 URINALS X $6.00 = , 3 TUBS X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = LAYS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT 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 = AREA,CASE,COIL,TRENCH, 11 FLOOR DRAINS CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, /e Co\ 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 = (Q 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = ICE AN/OR COFFEE MAKER,HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, AND R.P.B.P.D.FOR: VATS,TANKS, 17 CROSS CONNECTION DEVICE BOILERS X $6.00 = GREASE TRAP,SAND TRAP, 18 INTERCEPTORS 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 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE ❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: /$35.00 C// Card# VIN: TOTAL PERMIT FEE DUE: - 6-30 AUTHORIZED SIGNATURE: REVISED 8/26/05