2014, 01-10 Permit App: BLD-2014-0039 Water Heater •
Jan 10 14 02:25p Richard L Dixon 509 534 0934 P. 1
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Community Development w�rw.spokanevallev.ore.conr _
Plumbing Permit Application ❑ Commercial rtes dentiat
SITE ADDRESS
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Phone: (509)535— F: 19 5 9559--
Name: G43 STAT, MECHANICAL, Inc. } �_
Address: 5524 E. BOONS Ci SPO S -__WA zi, 3921
21-2 i
GOLDSM* 290C4 City BusinessDoenseNo
License No:
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Name: Phone:
DESCRIPTION!OF WORK #OF UNITS X COST = TOTAL AMOUNT
WATER CLOSET,( X - $6.00 =
2 TOILETS This document originally contained confidential credit ca
2 URINALS information which was redacted pursuant to I2CW 19.255.010
3 TUBS • and the original document destroyed
4 SHOWERS(PER TRAP) BATH,STALL ON-S G52014-030. y pursuant to SOS DAN
LAVS/BASINS,BAR,FLC
5 SINKS LAUNDRY.UTILITY.JAI,
• X-RAY.FOOD.PREPICt
-
6 DISHWASHER
7 CLOTHES WASHER =
8 T GARBAGE DISPOSAL Xi $6.00r
• •
=
9 WATER SOFTENER - x $6.00�1 = / CO
10 ELECTRIC H0-['WATERTANK
NOTE: IF GAS,SEE MECHANICAL l X $6.00 v
•
11 FLOOR DRAINS
AREA.CASE,COIL,TRENCH,CONDENSATE X $6.00 - _ _
ROOF DRAINS/OVERFLOW X $6.00
12 DRAINS
X $6.00
13 FOUNTAINS,DRINKING
WATER PIPINGJDRAIN-IN WASTE, NSTAL[ATIONR�ALTERATION,LION,REPAIR, X $6SALS .00 =
14 VENT,PLUMBING,REVERSAL
GRINDER,SUMP PUMP X $6.00 =
15 SEWAGE EJECTOR ICE AN/OR COFFEE MAKER,HOSE BIB, =
16 WATER USING DEVICE •
STEAMER X $6.00
PROOFER,CARSONATOR.SWAMP COOLER
VACUUM BREAKER,CHECK VALVE,
•
17 CROSS CONNECTION DEVICE _ AND R.P.B.P.D.GREFOR:
E R: VATS,TSTD N�TBOILERS X $6.00 =
•
18 INTERCEPTORS
CHEMICAL HOLDING TANK X $6.00 =
• 19 MEDICAL GASILerouHeQ
NITROUS,OXYGEN X $6.00 =-
MISCELLANEOUS
MISCELLANEOUS PLUMBING• X $6.00 =
20 FIXTURE =
- X $20.00 =
21 PRIVATE SEWAGE DISPOSAUSYS
INDUSTRIAL WASTEX $15.00 = _
22 _ INTERCEPTOR SUBTOTAL
METHOD OF PAYMENT: pROCESSING FEE- 6 .00
•
$37.00
0 CASH 0 CHECK 0 MASTERCARD — - _,
' EXPIRES: TOTAL PERMIT FEE DUE: 12.00
Bank card # REDACTED - - ' REDACTED ' -
REVISED VMS
SIGNATURE:. •
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01/16/2014 16:12 FAX 509 535 9359lli GOLD SEAL MECH. [ j001
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HP OfficeJet G Series G85xi Fax-History Report for /
Personal Printer/Fax/Copier/Scanner - Richard L Dixon
509 534 0934 v_
Jan 16 2014 8:21am
Last Fax
Dae -Dm Type Identifications Duration Pages Result
Jan 16 8:20am Sent 9-6880037 1:10 1 OK
Result:
OK - black and white fax
Okay color - color fax
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