2004, 10-18 Permit App: BLD-04-07944 Plumbing Fixtures PLUMBING PERMIT APPLICATION'^ 01\ City o/Spokane Valley Community Development Department
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4o, yet11707 E. Sprague Avenue, Suite 106
Spokane Valley,WA 99
(509)688-0036;
Fax: (509)688-0037
FOR INSPECTIONS, CALL(509)688-0056
Project Address: 6965 E ,e/>, Permit Use:
Owner: .05,5”.,.c /F«-..-„a,., Phone (Daytime Contact):
Mailing Address: i , / 1 5 -..- A 479? n
City State Zip Code
Contractor. it, r F,r..r-...c-L,i License#: Phone#: Z.-/-So 5 1
Mailing Address: '3„z/ hJ e.< /f. /zee' 7,., - e-t--.r- -s,, rt
Ry State Zip Coat
*OF - TOTAL
DESCRIPTION OF WORK UNITS X COST - AMOUNT
1 TOILETS WATER CLOSET,BIDETS 7 X 58.00
2 UUNALS X $ .0 =
3 TUBS X $6.00 -
4 SHOWERS(PER TRAP) BATH,STALL,ONSITE BUILT / X 58.00 =
5 SINKS LAVSIBASINS,BAR FLOOR,
KITCHEN.LAUNDRY,UTILITY, X $&00 =
JANITOR.PHOTO,X-RAY,FOOD,
PREP/CULINARYMMEAT
6 DISHWASHER _ X $ .00
7 CLOTHES WASHER X 58.0 ,=
a GARBAGE DISPOSAL X SB.00 =
9 WATER SOFTENER X S&W =
10 ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X $6.00 =
11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, X 58.00 =
CONDENSATE _
12 ROOF DRMNS/OVERFLOW DRAINS X 58.00 =
13 FOUNTAINS,DRINKING X $600 =
14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERAl1ON, X 66.00 =
VENT, PLUMBING,REVERSAL REPAIR,REVERSALS
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X 38.00 =
16 WATER USING DEVICE ICE AN/OR COFFEE MAKER
HOSE BIB,STEAMER,PROOFER X 56.00 =
CARBONiTDR,SWAMP COOLER
17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK
VALVE,ANDRP.B.P.D.FOR X 56.00 =
VATS,TANKS,BOILERS
ie INTERCEPTORS GREASE TRAP,SAND TRAP, X $9.00 =
CHEMICAL HOLDING TANK ,
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X 56.00 =
20 MISCELLANEOUS PLUMBING FIXTURE _ X $8.00 =
METHOD OF PAYMENT: SUBTOTAL
❑ CASH Q CHECK ❑ VISA 0 MASTERCARD PROCESSING FEE $35.00
CATE EXPIRES: TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: