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2004, 03-09 Permit App: BLD-04-03729 Piping
PLUMBING PERMIT APPLICATION SS02.1___ :3 , 91 et' City of Spokane Valley Community Development Departmente BuildingDivision Valle11707 E. Sprague Avenue, Suite 106 �] Spokane Valley, WA 99206 .0.0 �J 6 --- Phone: (509) 688-0036;Fax: (509)688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address: ` 7 / Permit Use: Owner: ( i-f3 __. .zia ,-- Phone (Daytime Contact): ?c73--- 9ge7g Mailing Address: 6 $(9 ‘ 5;04, 14LA.,,-4._ 9 gZ l Z City State Zip Code Contractor: at/Kt-Irv- License#: Phone#: Mailing Address: City State Zip Code #OF TOTAL DESCRIPTION OF WORK UNIT _X COST = AMOUNT 1 TOILETS WATER CLOSET,BIDETS s 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 = 5 SINKS LAYS/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 JANITOR,PHOTO,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 = 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, X $6.00 = CONDENSATE , 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, vX $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 15 SEWAGE EJECTOR GRINDER,SUMP PUMP ,X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, ` HOSE BIB,STEAMER,PROOFER, X $6.00 = CARBONATOR,SWAMP COOLER , 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D_FOR: X $6.00 = VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X_ $6.00 = METHOD OF PAYMENT: SUBTOTAL ❑ CASH 0 CHECK 13 VISA 13 MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: