2008, 12-16 Permit App: 08004800 Plumbing Fixtures•
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ne
.0,001rValley
Community Development
Plumbing Permit Application ❑ Commercial
Permit Center
11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
permitcenter(a,,spokanevalley.org
PERMIT NUMBER: 4' iCe
PERMIT FEE: /31
Residential
SITE ADDRESS:
i +2 y //e,
Building Owner
Name: j(e X
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Phone: 2� ,-9( S g Fax:
Address: /(� (( 62-
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City: ` f�tate:
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Contractor //Pr
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Y.Name:
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Phone:, ('� ^ g j Fax:
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Address: ti 7--zz.)
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City: Sv `� 1....,______ State:
Zip:
License No:
City Busin s Lic:
Contact
Name: i/ 4.
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Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
2
3
TOILETS
URINALS
TUBS
WATER CLOSET, BIDETS
J
X
$6.00
X
$6.00
X
$6.00
4
5
6
SHOWERS (PER TRAP)
SINKS
DISHWASHER
BATH, STALL, ON-SITE BUILT
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
X
X
$6.00
$6.00
$6.00
7
CLOTHES WASHER
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
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 DISPOSAUSYS
X
$20.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
METHOD OF PAYMENT:
DCASH ❑ CHECK
Card#
ISA ❑ MC
AUTHORIZED SIGNATURE:
REVISED 8rz6/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: