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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