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2006, 07-31 Permit App: 06002939 Plumbing Fixtures�� Permit Center ,opokane 11707 E Sprague Ave, Suite 106 Valley Spokane Valley, WA 99206 PERMIT NUMBER: 0_D1�( (509)688-0036 FAX: (509)688-0037 n Community Development www.spokanevallev.org PERMIT FEE: '): ` ) � Plumbing Permit Application n Commercial Residential SITE ADDRESS: 3 L Building Owner DESCRIPTION OF WORK Name: Phone: Fax: Address:_ City: r� State: Zip: Contractor WATER CLOSET, BIDETS Name: LPhone: $6.00 Fax: Address: City: State: Zip: License No: < 121 City Business Lie: X Contact = Name: Phone: AUTHORIZED SIGNATURE REVISED 8/26/05 DESCRIPTION OF WORK # OF UNITS X I COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 = Q 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 - METHOD OF PAYMENT: SUBTOTAL ❑CASH ❑CHECK El VISA El MC MC EXPIRES: FEE $35.00 TOTAL PERMIT FEE DUE: �7 ,c9e.;' Card# VIN: AUTHORIZED SIGNATURE REVISED 8/26/05