2008, 12-16 Permit App: 08004801 Plumbing Fixtures4 Z
Community Development
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
perm itcenter@sookaneval lev. ora
Plumbing Permit Application
n Commercial
PERMIT NUMBER: 4% O\
PERMIT FEE: ✓
Residential
SITE ADDRESS: /q5 5 Z % oiek
Building Owner
Name: /f /��
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7 Phone: 2 --t., O_ 9/ S g Fax:
Address: /, 9,
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City: s/-oi
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Zip:
Contractor
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Name:
Phone:
ax
Address: Ir,F
City:
L_State:
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License No:
City Business c:
Contact
Name:
Phone:
DESCRIPTION OF WORK
TOILETS
WATER CLOSET, BIDETS
# OF UNITS
X
COST
TOTAL AMOUNT
3
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
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY. FOOD PREP/CULINARY MEAT
I
X
X
X
$6.00
$6.00
$6.00
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
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
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
18
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
INTERCEPTORS
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
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
$6.00
X
X
$6.00
$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 ❑ CHECK ❑ VISA ❑ MC EXPIRES:
Card# VIN:
AUTHORIZED SIGNATURE:
REVISED 8/26/05
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: