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2009, 03-11 Permit App: 09000577 Water Heater
400°°.\41.r. Permit Center " na11703E Sprague Ave,Suite B-3 PERMIT NUMBER: sc a'ley Spokane Valley,WA 99206 .�/ r (509)688-0036 FAX:(509)688-0037 PERMIT FEE: Community Development www.spokanevalley.org Plumbing Permit Application n Commercial Residential SITE ADDRESS: 12 2 co n(A e C 1 c ,(A. P Building Owner w Name: 1 1 1;+'4 e_A 6 I i la l Phone: g — //?7 Q Fax: Address: 41/02. G`5-,,..,,, �j'/ct r►(J 4) City:S�D�L/✓!C`7�JLY l//e07 State:Lv/,i� Zip: 2 Contractor Name: Phone: Fax: Address: c2 20 /v L l7,%, City: f7B i,i/_e 5,,,;.. State: ��• Zip: 9'9,,,e/02_,License No: SPO�A F( 9,221-z— City Business Lic: T� c, amp Contact Name: ti)i I(G r-0( Phone: 902 G y 3'7 g' _ DESCRIPTION OF WORK `7 #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 WATER HEATER NOTE: IF GAS,SEE MECHANICAL X $6.00 = Com' 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, 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 = 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 DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X_ $15.00 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE ❑CASH ❑CHECK ❑VISA ❑MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: Effective October 28,2007 P:\Community Development\Forms\Building forms\Plumbing Permit Application.doc