2008, 03-06 Permit App: 08000750 Plumbing FixturesBuilding Owner
Petmit Crnter
i�T
Contractor µ
_
S
IE Sprague Ave, Sui a 106
S M Valley, W 992116
%,
PERMIT NUMBER: _ O
Name: Phone:
CommuniryDevelopmrnl
M)
509)68
()688-0016 FAX: (509)688-0037
wwwsmkenevelln.ore -
PERMIT FEE: -
IOF UNITS
Plumbing Permit Application✓�
❑ Commercial
Residential
SITE ADDRESS:
2 � #;—;'
- r
TOILETS
Building Owner
Name: Phone: Fu:
Address: City: Sum: Zip:
Contractor µ
Name: Phone: u:
Address: u City: Suu: �s/ 2ip:
D. o: City mess Dc:
Conud
Name: Phone:
DESCRIPTION OF WORK
IOF UNITS
X
COST
TOTAL AMOUNT
1
TOILETS
WATERCLOSET,BIDETS
X
MIX)
-
2
URINALS
X
.00
-
3
TUBS
X
56.00
-
4
SHOWERS ER TRAP
BATH STALL, ONSITE BUILT
X
56.00
-
5
SINKS
LAVSIEASINS. BAR. FLOOR, KITCHEN,
LAUNDRY. UTILITY, JANITOR. PHOTO.
X-RAY FOOD, PREPICULJNARY MEAT
X
58.00
=
6
DISHWASHER
X
50.00
-
T
CLOTHES WASHER
-
X
RIM
-
e
GARBAGE DISPOSAL
X
som
-
B
WATERSOFTENER
X
58.00
-
10
ELECTRIC HOT WATER TANK
NOTllFEOELM'ESECHANICAL
X
58.00ATRENCH,11
FLOOR DRAINS
E
X
W12
ROOF DRAINSIOVERFLOW DRAINS
X
58.00FOUNTAINS
DRINKING
X
SomWATERPIPINGURAINJNWASTE.
VENT. PLUMBING REVERSAL
NSTALION, REPAIR,14
X
58.00
-
15
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
50.00
-
16
WATER USING DEVICE
ICE MIIOR COFFEE MAKER. HOSE BIB,
STEAMER
PROOFER,CARBONATOR,SWAMP
COOLER
X
S8.0o
-
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND RP.B.P.D. FOR: VATS, TANKS,
BOILERS
X
Som
-
18
INTERCEPTORS
GREASETRFP.SANDTRAP,
CHEMICAL HOLDING TANK
X
$8.00
19
MEDICALGAS roueel
NITROUS OXYGEN
X
50.00
-
20
MISCELLANEOUS PLUMBING FIXTURE
X
Som
-
21
PRIVATE SEWAGE DISPOSALSYS
X
$20.00
-
22
INDUSTRIAL WASTE INTERCEPTOR
X
51500
-
METHOD OF PAYMENT:
OCASH ❑CHECKISA owEXPIRES:
CardN VIN:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
•®
AUTHORIZED SIGNATURE:
R ISEpe "5