2008, 08-14 Permit App: 08003178 Water SoftenerSpokane
jValleyP
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. spokaneval lc yore
PERMIT NUMBER:
PERMIT FEE: 14)
Community Development
Plumbing Permit Application (l Commercial ❑ Residential
SITE ADDRESS: 20 12 (.%+'N )se
Building Owner
Name:Fax:
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Phone: 9..2..2_9_30
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Address:
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City: 2 (hue/
State:
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Contractor
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Name:
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Phone: �o
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Fax:
Address: 5..2 2 th E 7Az7,->
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City: ils al,ct te., c
State:
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Zip: `9 q 2o2__,
License No: C MvK/ A F p 9 2) j'Z
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City Bus ess Lic: �/c S
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Contact
Name:
Phone:
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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
5
SHOWERS (PER TRAP)
SINKS
BATH, STALL ON-SITE BUILT
X
$6.00
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
6
DISHWASHER
X
$6.00
7
8
9
CLOTHES WASHER
GARBAGE DISPOSAL
WATER SOFTENER
X
X
X
$6.00
$6.00
$6.00
6 • 0—Z)
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
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 0 VISA 0 MC EXPIRES:
Card# VIN:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: