2008, 07-02 Permit App: 08002536 Mechanical Fixtures • Permit Center
Vialley
e 11703 E Sprague Ave,Suite B-3
Spokane Valley,WA 99206 PERMIT NUMBER: ��3 c
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: 5-7- '-
Community Development www.spokanevallev.or2
Plumbing PermitCApplication , Iry� r 1 Commercial Residential
SITE ADDRESS: 3 r72 B S. V C C`E 1\ Lk 5Poic.A4'€ Vie , tA-q6c `1/�
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Building Owner
Name: Phone: Fax:
MIKE ��213��C soPi- 951-x. 7S7(v
Address: 37 2 is> 5 V Ct� �f� City: 3001441,E V u e State: W A Zip: Citi�(
Contractor ( du'P �
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Name: t1/4k,V_L --C R34-il_ /� Phone: �34 9cq 7 S r 7/ „ Fax: d
Address: 3-7z.6 J j
• /� L�(e Z( L(. City: 500tL ✓ �L�� State: IA/Pr Zip: -/6)2,0(0
License No: City Business Lic:
Contact
Name: M t 4 l-. -rIJr�J�i Phone: �ti q 5�-4. '73 7/n
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 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 =
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, Q0
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, I ^
W
AND R.P.B.P.D.FOR: VATS,TANKS, c 3
17 CROSS CONNECTION DEVICE BOILERS X $6.00 = "`�`�J
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 =
19 MEDICAL GAS(per outlet) 5 NITROUS,� OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE .0. V. I X $6.00 = CD •CO
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
22 INDUSTRIAL WASTE INTERCEPTOR _ X $15.00 =
SUBTOTAL i C�CO
METHOD OF PAYMENT: ( Q
PROCESSING FEE
❑CASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00 C
Card# VIN: TOTAL PERMIT FEE DUE: 53.00
AUTHORIZED SIGNATURE:
REVISED 8/26/05