HomeMy WebLinkAbout2004, 08-25 Permit App: BLD-04-07455 Plumbing FixturesPLUMBING PERMIT APPLICATION / S
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Permit Use:
Phone (Daytime Contact): 9S/- c -/X-2
Project Ad �ress• (7•00V it • 6C.9 006(6 -9-P
✓9-
Owner. ,l5Woz_ . 7cJ4i 1.
Mailing Address.
Contractor. 01 -Oiler
Ma'ling Address:
City State Zip Code
License #: Phone #: ?ace -a -7
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code
DESCRIPTION OF WORK
*OF
UNITS
X
COST
-
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
/
X
56.00
=
2
URINALS
/
X
$6.00
=
3
TUBS
I
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
56.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
/
X
58.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
Et
GARBAGE DISPOSAL
X
56.00
=
9
WATER SOFTENER
X
38.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
)
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
//
o�
X
56.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$8.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICEAN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
58.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.BP.D. FOR:
VATS TANKS BOILERS
X
58.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
36.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
58.00
=
METHOD OF PAYMENT:
0 CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE EXPIRES
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
i "
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
Zip Code