2008, 04-30 Permit App: 08001645 Plumbing Fixtures.00jValley
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www.spokanevallev.ort,
Plumbing Permit Application
PERMIT NUMBER: /6,q
PERMIT FEE: '�(�
Commercial "'1 Residential
SITE ADDRESS: 3 , cfD `y _
Building Owner
`6^
�J is �-A
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
Contractor
��_)o�
. \ i-`
t
Name: �Nt-�
C t-^E.t•
Phonte: aQg _ 3
/
�_
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
Phone:
DESCRIPTION OF WORK
1
TOILETS
WATER CLOSET, BIDETS
# OF UNITS
X
COST
TOTAL AMOUNT
1
X
$6.00
2
URINALS
X
$6.00
3
TUBS
X
$6.00
4
5
6
SHOWERS PER TRAP
SINKS
DISHWASHER
BATH, STALL, ON-SITE BUILT
7
CLOTHES WASHER
8
9
10
GARBAGE DISPOSAL
WATER SOFTENER
ELECTRIC WATER HEATER
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
NOTE: IF GAS, SEE MECHANICAL
1
X
X
X
$6.00
$6.00
$6.00
X
$6.00
X
X
X
$6.00
$6.00
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
cc.
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
15
16
17
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
GRINDER, SUMP PUMP
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
X
X
$6.00
$6.00
$6.00
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
METHOD OF PAYMENT:
['CASH 9 CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
AUTHORIZED SIGNATURE:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
Effective October 28, 2007
P:\Community Development\Forms\Building formsWlumbing Permit Application.doc