2008, 05-29 Pemrit App: 08002029 Plumbing Fixturesr..
l'r Penmit Center
Lf2LLdL' 11703 E Sprague Ave, Suite B-3
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
Community Developmentwwwspp keven allev.orr
PERMIT NUMBER: 2_02_9
PERMIT FEE:
Plumbing Permit Application ❑ Commercial ghesidential
tct
SITE ADDRESS: /4 /0(l/ ti CP y gRc LC14—
Building Owner
Name: tie vw l"et5
pet
u
Phone: ce) -. —6063D Fax:
Address: '
City: Cceyie lue Stuce:W 4
Zip:
/ s{ O& E 6 —
Contractor
Name:
Rose $r2J5p-t /� us-1,.vq
Phony.
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Address: en,5 Rosee /
City: mai telt 40 _At state;wl¢
Zip: 95902-2_
License No: RD s& -SP Oa St el
City Business Lie: 6o/. aha- 895'
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Contact
IV' ����
Nam: /rlLE,tih l Jn/ rS011/4_
Phone: re9-zzo-SaYO
DESCRIPTION OF WORK
It OF UNITS X COST • TOTAL AMOUNT
TOILETS
WATER CLOSET, BIDETS
I
X
Sem
0
2
URINALS
X
56.00
TUBS
1
x
58.00
co
4
SHOWERS (PER TRAP)
BATH, STALL, ONSITE BUILT
X
$6.00
SINKS
IAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD PREP/CULINARY MEAT
X
56.00
e
DISHWASHER
X
56.00
7
CLOTHES WASHER
X
58.00
8
GARBAGE DISPOSAL
X
58.00
9
WATER SOFTENER
X
56.00
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
x
$8.00
11
FLOOR GRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
56.00
12
ROOF DRAINS/OVERFLOW DRAINS
X
58.00
13
FOUNTAINS, DRINKING
X
$8.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
58.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
56.00
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
56.00
10
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
20
MISCELLANEOUS PLUMBING FIXTURE
X
56.00
21
PRIVATE SEWAGE DISPOSAUSYS
x
520.00
22
INDUSTRIAL WASTE INTERCEPTOR
X
515.00
METHOD OF PAYMENT:
DCASH
Card*
HECK D VISA DMC
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
.59.E
AUTHORIZED SIGNATURE:
Effective October 28, 2007
P1Community Development\Fonns'Building fommswlumbing Permit Application.doc