2004, 05-27 Permit App: BLD-04-04460 Sprinkler System ,.'.. Received: 4/13/04 10:32AM; _> Haase.'Landscape nc. ;..,,.:-;age.
APR 13 2004 10:10 FR TO 9260271 P.01/01
alt � PLUMBING PERMIT APPLICATION
�q�p City of Spokane Valley Community Development Department
e BulldingDivision
ley 11707 E. SpragueAvenue, Suite
106
400,ValSpopokaneneWA 9 Valley, 06
Phone: (509)688-0036;Fax; (509)688-0037
FOR INSPECTION, CALL(509) 688-0054
Project Address: S 3 1 5 G to Permit Use:
Owner: t t"'\ Wick ASO 4'\ Phone (Daytime Contact):
Mailing Address: L S i 5 S jDo c W A "t q ZD 6
ii '' City State Zip Code
Contractor: 1r a�s i L Y s cc,p z License#: Phone*:
Mailing Address: E. 1 ZZ o Z T\I\o-PC- LS�aa�G �t WA (79Z-06
City State Zip Code
#OF TOTAL
DESCRIPTION OF WORK UNITS X COST • AMOUNT
1 TOILETS WATER CLOSET.BIDETS X $6.00 =
2 URINALS X $6.00 a
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, X $6.00 =
JANITOR.PHOTO.X-RAY,FOOD,
PREP/CULINARYIMEAT
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, X $6.00 =
CONDENSATE
12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 =
13 FOUNTAINS,DRINKING X $6.00 =
14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION.ALTERATION, X $6.00 =
VENT, PLUMBING,_REVERSAL REPAIR,REVERSALS _ -
15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 =
16 WATER USING DEVICE ICE AN/OR COFFEE MAKER,
HOSE BIB•STEAMER,PROOFER• X $6,00 =
CARBONATOR,SWAMP COOLER
17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK
VALVE,AND R.P.B.P.O,FOR: X $8.00 = . 0 0
VATS,TANKS,BOILERS _
18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 =
CHEMICAL HOLDING TANK
19_ MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 =
20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 =
METHOD OF PAYMENT: SUBTOTAL
0 CASH 0 CHECK ❑ VISA 0 MASTERCARD PROCESSING FEE $36.00
DATE: EXPIRES: TOTAL PERMIT FEE DUE L/Z • 00
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: