2006, 12-11 Permit App: 06004780 Plumbing FixturesPermit Center
Spokane 11707 E Sprague Ave, Suite 10
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688
Community Development www.spokanevallev.or2
Plumbing Permit Application
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C E BVI F
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EC 1 1 2006
Commercial I Cesidential
PERMIT NUMBER: `I%
PERMIT FEE:
SITE ADDRESS: I $,01.0 ) [UJ i ei 1I
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Building Owner
Name:
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Phone: Fax:
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Address: 1 $la $- E gth �VZ
City:5po�ne VaJ (eel State: wA Zip: 196 ii.,
Contractor
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/
Name:
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Phone:
Fax:
Address:
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City: 5
ka ve v4 kState:
vU)4 Zip: 901)' / _
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License No:
idol g3 , y 7�
City Bust
p •ps
s Lic: C C J
U �K4ucEN 50-2,31- 6
Contact
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Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS X
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
2
3
4
5
6
URINALS
TUBS
X
$6.00
X
$6.00
SHOWERS PER TRAP
SINKS
DISHWASHER
BATH, STALL, ON-SITE BUILT
X
7
8
CLOTHES WASHER
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
2
X
$6.00
$6.00
$6.00
X
$6.00
GARBAGE DISPOSAL
X
$6.00
9
WATER SOFTENER
X
$6.00
10
11
12
ELECTRIC HOT WATER TANK
FLOOR DRAINS
ROOF DRAINS/OVERFLOW DRAINS
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
X
$6.00
13
FOUNTAINS, DRINKING
X
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
x
Moo
15
16
17
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
GRINDER, SUMP PUMP
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
18
19
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
X
X
$6.00
$6.00
$6.00
X
$6.00
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:
❑CASH ❑ CHECK VISA ❑ MC
Card#
AUTHORIZED SIGNATURE:
REVISED 8/26/05
EXPIRES:
VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE: