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2008, 03-28 Permit App: 08001103 Plumbing Fixtures
Permit Center `rt',rkaIIe 11703E Sprague Ave,Suite B-3 ley Spokane Valley,WA 99206 PERMIT NUMBER: (509)688-0036 FAX:(509)688-0037 �� PERMIT FEE: Community Development www.spokanevall ev.orU Plumbing Permit Application Commercial ❑ Residential SITE ADDRESS: _ /3'/o 5 /:- t/et /4�/`� ii,av ea ve Building Owner Name: d. /C / e p, Phone: 92_7 0/ 7Fax: Nom' h ,/ Address: a Li 0 5 J- / //e. w a v City: State: Zip: Contractor Name: /-T-Z r _, dans -- Phone: £, S6.., 3 6.,:c„-7 Fax: Address: City: State: Zip: License No: City Business Lic: Contact 7e'x4 Name: Phone: /I.5� S ! 7 — DESCRIPTION OF WORK 1'#OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = 6 "--' 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6.00 = L LAYS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT / v 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 , = 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 1 X $6.00 = 4 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 DISPOSAL/SYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = SUBTOTALN METHOD OF PAYMENT: / PROCESSING FEE ❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: $9 AUTHORIZED SIGNATURE: �..,ZC_- . REVISED 8/26/05