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2006, 03-16 Permit App: 06000889 Plumbing Fixtures
_ #00Permit Center S O ] PERMIT NUMBER:2 11707E Sprague Ave,Suite 106 op..c-lf p Spokane Valley,WA 99206 v�eY (509)688-0036 FAX:(509)688-0037 c-c. Community Development www.sookanevallev.org..com PERMIT FEE: Plumbing Permit Application ❑ Commercial [gesidential SITE ADDRESS: /5 92,/ °'< . Ge L7 Bnilding owner . r Name: J - i t (.. ,. �', /n:../r__ Fax:Phone: 7/ - C.,' Address: / 49'2,,/ y h City J/I,� c f t. State: 14_ Ai Zip: 9 s c 2 Contractor . Name: (JEMIS - tiMe0/0/& Phone: q.t& Sioia Fax:9Z6'S( 9 Address:5 . /Q(p £Pf22 ,), City:6egat1tick,-E3 State:j ,9- Zip: 440/Le License No:Atil/nagitilagaft L E12RYP'IC 138 NO City Business License No: 600 Lao 7/4 •Contact. : , :.i - .i. r - .•. ... . .:. -..r • - • • .. s. Name: dam/ lia7E 5 Phone: gZ(o•Sip/e) DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = 4 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6.00 = 6, LAVS/BASINS,BAR.FLOOR,KITCHEN. 5 SINKS LAUNDRY,UTILITY,JANITOR PHOTO, r� X $6.00 = X-RAY,FOOD,PREP/CUUNARY MEAT 2 /2, `J 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 =- 6 B 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,CONDENSATE X $6.00 = ROOF DRAINS/OVERFLOW 12 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, 17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR VATS.TANKS,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 = MISCELLANEOUS PLUMBING • 20 FIXTURE X $6.00 21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 = INDUSTRIAL WASTE 22 INTERCEPTOR X $15.00 = • SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE 0 CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00 Card# EXPIRES: TOTAL PERMIT FEE DUE: • AUTHORIZED SIGNATURE: REVISED 8rz6/os