2006, 09-05 Permit App: 06003527 Water Piping JP;ok&ne ® ]1707 E Sprague Ave,Suitt 106 PERMIT NUMBER: --)-5
moi`Ll Spokane Valley,WA 99206
(509)666-0036 FAX:(509)663-0037 PERMIT FEE: if J_4�
Community Development u-vw.svnkanevallev.cr.
' Plumbing Permit Application ,1 ❑ Commercial ® Residential
SITE ADDRESS: /O S0S t gjn AI
Building Domer /1(An �Aii/OsCAc _ - - -
Nam: ,1 Phone: SC x:
/Cy 891 9I9V FaC
Address: IG ROS L CC1 4r\ 40 City Sp66tcl n es. state: I.1 A_ gip: 9 110 6
Contractor _,
Nims: Phone Fax:
Address: City: State: Zip:
License No: City Business Lit:
Cvve .Name: Phone:
DESCRIPTION OF WORK S DF UNITS X COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
2 URINALS X $8.00 =
3 TUBS X $8.90 =
4 SHOWERS(PER TRAP) BATH.STALL.ON-SITE BUILT X $6.00 •
LAVSBASINS,BAR,FLOOR,KITCHEN.
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT
6 DISHWASHER X $6.00
7 CLOTHES WASHER X MOD =
8 GARBAGE DISPOSAL - _X $6.00 =
9 WATER SOFTENER X $6.00 =
10 ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL X 16.00 a
AREA.CASE,COIL TRENCH,
11 FLOOR DRAINS CONDENSATE X 58.00 =
12 ROOF DRAINS/OVERFLOW DRAMS X $6.00
13 FOUNTAINS,DRINKING X $6.00
WATER PIPING/DRAIN-1N WASTE, NSTALLATION,ALTERATION,REPAIR,
14 VENT,PLUMBING.REVERSAL REVERSALS I X $6.00 •
15 SEWAGE EJECTOR GRINDER,BUMP PUMP X MOD =
ICE AN/OR COFFEE MAKER,HOSE BIB,
16 WATER USING DEVICE STEAMER - X $8.00
PROCTER.CARBONATOR SWAMP
COOLER
VACUUM BREAKER,CHECK VALVE,
AND RP.B.P.D.FOR VATS.TANKS,
17 CROSS CONNECTION DEVICE BOILERS X $B.DO
GREASE TRAP,SAND TRAP,
18 INTERCEPTORS CHEMICAL HOLDING TANK X 35.00 =
19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00
20 MISCELLANEOUS PLUMBING FIXTURE X $500 =
21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 =
22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 =
METHOD OF PAYMENT: SUBTOTAL
PROCESSING FEE
OCASH 0 CHECK 0 VISA 0 MC EXPIRES: $35.00
Card* VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 1/26L3