2014, 11-12 Permit App: BLD-2014-2749 Plumbing FixturesSpokane 11707 E Sprague Ave, Suite 106; Uj 2Ct #M-9011±-___74
nn rr
Valley
Permit Center
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 RECEIVE D
Community Development w•ww_spokanevalley.org.eom
Plumbing Permit Application
❑ Com
11
r ii2l A. Re
sBu�lc7m.g owneraas5 a�xz.x
_
_ ? . , v'
# OF UNITS
X
_t
- «.,-,-1.''''
_
-.1 rx
WATER CLOSET, BIDETS
Name: 'D ra. ✓l`c," c) �L K
Cpit S 1.
c jj.p
I P ne: gZJi14k y
Fax
2
URINALS
X
Address:
=
City
State
Zip
X
$6.00
=
) Z
4
ae. - traF or ' � �,,,
-n'�''
,
i:�Y.....
�-'n�4�M'�#"cf��-7✓1, .-�' " ,�
pig xp s �
3�
— 3_
�
.-,tee, �i, C
s �r T',L'',,j�, .
.. �_...�
Name: Gold sea]
.a.
Phone: Fax:
$6.00
.
30
!'''
DISHWASHER
Address:
(
City State
$6.00
Zip
(O
7
CLOTHES WASHER
License No:
1
City Business License No:
$6.00
=
(0
8
GARBAGE DISPOSAL
:ontlr2 _:xt ,� u e •
_nc,.a {.
l ,<
�.. . _,ter
-'"a..y ,.�, - n .- ...�:N
a� K5:* 0.? :y� v h ..
$6.00
s
yx t,�
9
WATER SOFTENER
Name: �fl�
Phone: Z( (- (,(9Z'i
$6.00
=
10
ELECTRIC HOT WATER TANK
AUTHORIZED SIGNATURE:
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
2
X
$6.00
=
-
/Z.
2
URINALS
X
$6.00
=
3
TUBS
1
X
$6.00
=
) Z
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
1
X=
$6.00
(0
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
5
X
$6.00
=
30
6
DISHWASHER
(
X
$6.00
=
(O
7
CLOTHES WASHER
1
X
$6.00
=
(0
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
-
Z
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 0 CHECK
DATE:
SUBTOTAL
8 y
0 VISA 0 MASTERCARD
PROCESSING FEE
$35.00
EXPIRES:
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05