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2007, 03-21 Permit App: 07000878 Plumbing Fixtures Permit Center S _ ne 11707 E Sprague Ave,Suite 106 PERMIT NUMBER: sV�ley Spokane Valley,WA 99206 �// (509)688-0036 FAX:(509)688-0037 PERMIT FEE: Community Development www.spokanevallev.oru Plumbing R !/l Permit Application ❑ Commercial ❑ Residential G, SITE ADDRESS: _ '(- �6 / S /'1 v Tl� y ��� (A)/--1, Cf / Z Ej Building Owners Name: ltd u� 4 i✓61 Y' A '8 F'COH 1A�L D I Phone: , ,-5-^f3 1 /l9(0lX Fax: Address: l.)3 �^ c.. ) c, 1,, 7 D, City: ,,--„o rA j 1,', ,A C/C{$tate: 1.,,/A Zip: 9 ( )06 Contractor Name: Co : 'j -,--6 4 Foe Phone: 8- 7cC7 6 Fax: A.16_.:75-/ •••) � ' Address: K1 Ei .') RCity: ( p, A.1.:.,,,,,,_ State: f, Zip: C License No: c C? r\ ,TA iw T i,,) i.-) City Business Lie: 6 C � 9 Ci, Contact Phone: `�—C3 9 '20 7 S Name: � ri . .C.. ( / DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = 2 URINALS X $6.00 = 3 TUBS / X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = LAVS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL X $6.00 = AREA,CASE,COIL,TRENCH, 11 FLOOR DRAINS CONDENSATE X $6.00 = 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 METHOD OF PAYMENT: PROCESSING FEE ❑CASH CHECK ❑VISA ❑MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: )b( )<? /� /, REVISED 8/26/05 / /