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2007, 12-04 Permit App: 07004748 Plumbing Fixtures Permit 0-7(Y '—f..74g Center ,11,E 11703 E Sprague Ave,Suite B-3 PERMIT NUMBER® "���/` S Spokane Spokane Valley,WA 99206 jUalley. www.s8(509)688-0036 FAX:(509)688-0037 PERMIT FEE: `' www.s okancvallev.or2 Community Development Plumbing Permit Application n Commercial [7 Residential SITE ADDRESS: (p ti( ' ES44-- A C • Building Owner l./n 1 /OkG r s O,J Name: � Phone: Fax: n� Address: /r( e- ! City: 5/4 L V�f j<, State: 14)4 , Zip: Contractor (, Name: 4 f ( , ,,,,,w,,_,,,, Phone: Fax: Address: O O , 6o)- 317 f `'I City: State: Zip: License No: rQt c4(c PN- 1( 1D DI- City Business Lic: Contact ` at-- Name: Phone: DESCRIPTION OF WORK #OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = 4-0 0 2 URINALS X $6.00 = 3 TUBS X $6.00 = / 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT 1 X $6.00 = (� •°t) LAVSBASINS,BAR,FLOOR.KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY.FOOD,PREP/CULINARY MEAT / 6• 00 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 18'•cac� METHOD OF PAYMENT: O PROCESSING FEE OCASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00 Card# a,ze, VIN: TOTAL PERMIT FEE DUE: Se3 •c9) /la AUTHORIZED SIGNATURE: REVISED 8/26/05