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2015, 05-18 Permit App: BLD-2015-1145 Plumbing Fixturesi Permi [Center Project #X 15 - l I ,5 " 11707 E Sprague Ave, Suite 106 ©kale Spokane Valley, WA 99206 RECEIVED valley (509)688-0036 FAX: (509)688-0037 /y Community Development www.spokanevalley.ore.com ., 0 1n1t` ❑ Commercial %Residential Plumbing Permit Application SITE ADDRESS 113/I £- SG%nOOe"1rt Dr `�" DPpm11- rPn)TCR 4n .N$'v y7s ily m ingownpr �' ioe_e.:tii+ +r;E,•, S t, -Vi Y Y -i^{, 4 +-4, SY +IL-^fr '-x�`.a }L Y 3. 3 is �, .,l' .A.,A}� f,�-.,y� *_.Ck � * s � �.-. Z+u 4 •< �i� : j _ ; .. ,.. ,' - _ - _ r 4- , w.. �:1•:N.:1. 3 x ��� r .x ; ...- M ` . Name: lt/ j G, #enayt� jZ J. CWl ,1 - Phone: Fax TOTAL AMOUNT 1 TOILETS Address: City State Zi . X $6.00 :k k tr?c, r z `-26" LJ,H0,,,_.yi b`+b. 5 •: ([yam-�t,: - f ''~ . �,, .,R � X57. }`"f- > 3 '� `ti. _n3 v4 ._c .;..f�`irwir F` 5-.-:•=m, `=.r'+$ . -'?: w tic �i,-6-- - .. .._4 .:` 9+ Name: Golf) .:3 .. aJ •LA /AL 171C) Phone: Fax: ... = Address: / City State Zip Z X License No: City Business License No: I Z 4 SHOWERS (PER TRAP) �'' a i.. o ... ems. a L',. 'f ��. � :fi }.. 5 '.TM`c l 3 _`.tv�v.' ::r'T# F�'7 n 'i '.,,/''''','";')'s �.+^.t„t A'15-''''''.r"'Y,,, ' �L,'.'Y.l •�' �' T...X �p .'}.�.:aE�- yr k :s y-, �c`�k ' '=a,+at 4:0Fi°s,.v .H:-t05ra_M�•y' P• .`.3'`�nW}: '.t ��L ..:=%"F+•-'1-9. tt _ +rte'_ ;. +G�' P+1Y4V,,.. Name: Phone: SINKS LAYS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 5 AUTHORIZED SIGNATURE: REVISED 8/26/05 DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS Z X $6.00 = 12- Z2 2 URINALS X $6.00 = 3 TUBS Z X $6.00 = I Z 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 1 X $6.00 = 6 5 SINKS LAYS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 5 X $6.00 = - 0 6 DISHWASHER I X $6.00 = 6 7 CLOTHES WASHER l X $6.00 = ,6 8 GARBAGE DISPOSAL I X $6.00 = b 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, REVERSALSX $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 DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = METHOD OF PAYMENT: ❑ CASH ❑ CHECK ❑ VISA 0 MASTERCARD DATE: EXPIRES: SUBTOTAL cfP PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05