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2007, 12-05 Permit App: 07004771 Plumbing Fixturesj Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 Community Development (509)688-0036 FAX: (509)688-0037 OP wwwsookancvalleY.org Plumbing Permit Application ❑ Commercial PERMIT NUMBER Lel 7 PERMIT FEE: Residential SITE ADDRESS: )S /I U TT. S "` %QVC Building Owners /lin a1 Name: ra'j Aie / Phone: -'11) no ..6-7a.3 Fax: Address: City:: an ! nom`..\ _� State: /J./1 LeW ` I I'T Zip9y<7 p 1 t2 C 1 �,, 1 �/�+—� (+�i ` Contractor sIda2 V\ i u Lye 7CX " _.. Name: Phone 7Eax: - Address, 5.0(815- Cty:x}_ FO WS State:Irk Zip::63677 License No: Sy' ap City Business Le: r.v contatti u T\Yl, Name: Phone: &M—p32_55') 7 DESCRIPTION OF WORK # OF UNITS X COST • TOTAL AMOUNT TOILETS WATER CLOSET. BIDETS X $6.00 e 2 URINALS X $6.00 TUBS X $6.00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT x $6.00 5 SINKS LAVS/BASINS. BAR, FLOOR, KITCHEN. LAUNDRY. UTILITY, JANITOR. PHOTO. X-RAY FOOD, PREP/CULINARY MEAT X $6.00 6 DISHWASHER x $6.00 7 CLOTHES WASHER X $6.00 8 GARBAGE DISPOSAL x $6.00 9 WATER SOFTENER X $too 10 ELECTRIC WATER HEATER NOTE: IF GAS. SEE MECHANICAL X $6,00 11 FLOOR DRAINS AREA, CASE. COIL, TRENCH. CONDENSATE x $6.00 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS, DRINKING X $6.00 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS X 0.00 15 SEWAGE EJECTOR GRINDER, SUMP PUMP $6.00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATCR. SWAMP COOLER X $6.00 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE. AND R.P.B.P.D. FOR: VATS. TANKS, BOILERS X $8.00 18 INTERCEPTORS GREASE TRAP. SAND TRAP, CHEMICAL HOLDING TANK $6.00 19 MEDICAL Gas (per outlet) NITROUS. OXYGEN X $6.00 20 MISCELLANEOUS PLUMBING FIXTURE x $6.00 21 PRIVATE SEWAGE DISPOSAL/SYS X $20.00 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 METHOD OF PAYMENT: OCASH C CHECK VISA 0 MC Card# AUTHORIZED SIGNATURE: REVISED V26/05 SUBTOTAL PROCESSING FEE TOTAL PERMIT FEE DUE: $35.00 V7 -a'