2008, 10-14 Permit App: 08004073 Plumbing Fixtures (Staff Use Only)
nePERMIT NUMBER:
17dalky' PERMIT FEE: q
CITY OF SPOKANE VALLEY
Community Development Department
Permit Center
11703 East Sprague Avenue, Suite B-3
Spokane Valley, WA 99206
Tel: (509) 688-0036
Fax: (509) 688-0037
permitcenter@spo kanevalley.orq
PLUMBING PERMIT APPLICATION
0 COMMERCIAL ® RESIDENTIAL
SITE ADDRESS:123 N.WALNUT
BUILDING OWNER NAME:RYAN LIEUALLEN
NAME:RYAN LIEUALLEN
ADDRESS:123 N.WALNUT
CITY:SPOKANE VALLEY STATE:WA ZIP:99206
PHONE:(509)481-7068 FAx:N/A cELL:(509)481-7068
CONTACT NAME:RYAN LIEUALLEN
PHONE:(509)481-7068 FAX: CELL:(509)481-7068
CONTRACTOR NAME:N/A
MAILING ADDRESS:
CITY: STATE: ZIP:
PHONE: FAX: CELL:
CONTRACTOR LICENSE No.: EXPIRES: CITY BUSINESS LICENSE NO.:
Effective October 28. 2007 Paae 1 of 2
V
DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS 1 X $6.00 = 1
2 URINALS X $6.00 =
3 TUBS 1 X $6.00 = 1
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT 1 X $6.00 = 1
LAYS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, 3 X $6.00 = 3
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER 1 X $6.00 = 1
7 CLOTHES WASHER 1 X $6.00 = 1
8 GARBAGE DISPOSAL 1 X $8.00 = 1
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 = 1
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 =
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
DISCLAIMER
The permitted verifies, acknowledges and agrees by their signature that: 1)if this permit is for construction or on a dwelling,the dwelling is/will
be served by potable water. 2)Ownership of this City of Spokane Valley permit inure to the property owner. 3) The signatory is the property
owner or has permission to represent the property owner In this transaction. 4) All construction is to be done in full compliance with the City of
Spokane Valley Development code. Referenced codes are available for review at the City of Spokane Valley Permit Center. 5) The City of
Spokane Valley permit is not a permit approval for any violation of federal, state or local laws, codes or ordinances. 6) Plans or additional
information may be requiredto./be sub I ed d subsequently approved before this application can be processed.
Signature Date: 7',//,2;P--
Method
,/Method of payment: ❑ Cash ❑ Check ❑ Visa ❑ Mastercard
Bankcard #: EXP: VIN#:
Authorized Signature:
Effective October 28. 2007 Paae 2 of 2