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2007, 06-12 Permit App: 07002229 Plumbing Fixtures
(-) Permit Center 1.1 Spoken e ` 11707 E Sprague Ave,Suite 106 PERMIT NUMBER:J 7 O(�D jb.T Spokane Valley,WA 99206 ` ��Valley (509)688-0036 FAX:(509)688-0037 Community Development �t.�v ,v.spokanevalley.ore PERMIT FEE: Plumbing Permit Application n +n Commercial 171.Residential SITE ADDRESS: /0 I '2.- Al Ll/c .)- /C GL t.:1-7- -L' Building Owner 4 12(21.4.7-LL i.,, lei,,Q v., ti`l'l Name: D I4 2 eL L L k; R,„4 ✓/ N Phone: 1a c ' '.lam,fv,S� Fax: 3 Address: //0"7 N .4(4_cia g p_ae,,2 02 l) City: S/7,6.ile/l I/'4. State: (Ai)4ZIp.9�coG7 (n Contractorpa v., ,Lje do vs.'71 Name: � - Phone: q2Fax: Address: /iU 7 It) 11,74C",Fvr''f!'t (:,L.fQ Q .1� City: S F'v14q ,t,P, 1,L.�/ State: 1.0_, Zip: r�0 6License No:- 9 6, 1 .. cf c?�L- City Business Lie: �ov 2. Contact il122e-Li_(_ 1„..._ -1-2,„,,,, Name: Phone: 9 `f 1 L fa s.e DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS o11- X $6.00 = I L. ca C? 2 URINALS X $6.00 = 3 TUBS 1- X $6.00 = a. 0 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $6.00 = 1:,,, e C3 LAYS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT &'.("c3 j 6 DISHWASHER 1 X $6.00 = 6. 0- 7 . '7 CLOTHES WASHER 1 X $6.00 = 4, , CJ 0 8 GARBAGE DISPOSAL I X $6.00 = 4.o 0 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL I. X $6.00 = c, 0 C, AREA,CASE,COIL,TRENCH, -1 4t C3 11 FLOOR DRAINS CONDENSATE t X $6.00 = QCs, 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 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, 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 DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = SUBTOTAL G3� METHOD OF PAYMENT: 72 `� PROCESSING FEE ❑CASH [CHECK ❑VISA 0 MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: l07. AUTHORIZED SIGNATURE: ad-X-1-11 0 0-41-4-fc--e-' REVISED 8/26/05