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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 = 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: �� I f AUTHORIZED SIGNATURE: it REVISED 8/26/05