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2007, 08-07 Permit App: 07003079 Plumbing Fixtures
�C/ —► Permit Center $Nati 11707 E Sprague Ave,Suite 106 ll PERMIT NUMBER: '. , .� � Spokane Valley,WA 99206 7 (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 3 / Community Development www,spokanevallev.ore _ Plumbing Permit Application fCommercial Residential — SITE ADDRESS: j ! 5 ,20 E 6T* /4 V^? ,_;7.00,_,r / //aj Iii/Q p Y ,o6 Building Owner /i_f.,.....-.)„el. ,� /1ric mac/ (6Oy/ 4?S-94'/3 Name: Phone: Fax: Address: g t!e!`►i1'( v City: ri� alr_a,'I-E' State: LA;�'. Zip: C�'t� t.., 6 Contractor �C 'ci e fp( 1 C. Name: S e r� / O Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = l 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, i 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 0 VISA 0 MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05