2007, 07-31 Permit App: 07002987 Water pipingPermit Center x
Spokane 11707 E Sprague Ave, Suite 106 PERMIT ^ ER: (J /
Valley Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037 /
Community Development www.spokanevallev.orQ PERMIT FEE 1
Plumbing Permit
Application jy ❑ Commercial ;❑'Residential
SITE ADDRESS:—! Z `I C
Building Owner
DESCRIPTION OF WORK
Name: e ttie Auv v'r1� rv�
Phone:
Fax:
Address:- / -ZL E C/1r
Clry
State: << 7 Zip: G-'�%
Contractor
WATER CLOSET, BIDETS
Name: ._ 1" Lt
x 5—Y✓�-t,;
Phone: cJ Z Z _ 1 j"t� /
Fax:
Address: 14 IL/
City:
State:, Zip: Gc
License No:
City Business Lic:
X
Contact
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Name: I L' �; C}U v r i�Ar rvt
Phone: �'1 Z L( L(�
AUTHORIZED SIGNATURE: it
REVISED 8/26/05
DESCRIPTION OF WORK
# OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
-
4
SHOWERS PER TRAP
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
-
8
GARBAGE DISPOSAL
X
$6.00
=
9
WATER SOFTENER
X
$6.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
-
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
$6.00
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
-
19
MEDICAL GAS(per outlet
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
CASH El CHECK ❑VISA El MC
MC EXPIRES:
/Card# VIN:
SUBTOTAL
FEE
$35.00
TOTAL PERMIT FEE DUE:
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AUTHORIZED SIGNATURE: it
REVISED 8/26/05