2005, 06-30 Permit App: 05002245 Sewage EjectorPLUMBING PERMIT APPLICATION
Phone: (509) 688-0036; FAX: (509) 688-0037
For Inspections, CaII (509) 688-0054
Community Development Department
Building Division
Sprague Avenue, Suite 106
9206
Project Address: -3 0 `I ,G 1 k/`{ (I el W ��%
rmit Use:
Owner. �J `` 99 ` Phone (Daytime Contact):
lr. \J
Mailing Address' 3Q1-1 . 5 C, (Q.q (/,�City.1 $ 9» / .,'4--
I I I ( tate . Zip Code
Contractor eh i L` '�a,-0. \ TeUt yr\ License #: PDr Teitl Y6/DaPhone #: , Fag- 2 /c -
Mai ing Address: i (I -I I q -1 57, 26 * ii -v2 5pK4he U41[ey IA
City State `zcp clod
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
0 5-- -3153
DESCRIPTION OF WORK
0 OF UNITS
`X
COST .
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
56.00
=
3
TUBS
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
55.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
8
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$8.00
6
GARBAGE DISPOSAL
X
35.00
=
9
WATER SOFTENER
X
58.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$8.00
=
11
FLOOR DRAINS
AREA, CASE, COIL TRENCH, CONDENSATE
X
36.00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
$6.00
=
-
13
FOUNTAINS, DRINKING
X
56.0D
=
14-
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATTON, ALTERATION, REPAIR,
REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
a
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
36.00
=
17
CROSS CONNECTOR DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS, TANKS, BOILERS
X
36.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
36.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAL/SYS
X
$20.00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
515.00
=
METHOD OF PAYMENT:
0 CASH ❑ CHECK
DATE
SUBTOTAL
0 VISA 0 MASTERCARD
' PROCESSING FEE
$3S.0/Q')'1
EXPIRES:
TOTAL PERMIT FEE DUE:
4f ( . W
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
0 5-- -3153