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2005, 02-28 Permit App: 05000580 Drain, Piping . c3---__ 5-g 6, PLUMBING PERMIT APPLICATION Community Development Department .,�n Building Division ine Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106 do/Valley For Inspections, Call (509) 688-0054 Spokane Valley, WA 99206 Project Address: (p9 0� E. lo ` Permit Use: Owner: VA,a_ i„�e- •J-c,w`5 Phone (Daytime Contact): Mailing Address: City State Zip Code Contractor: (l u,i1iu- ,ro k..Lb,M, Mf_ --' License#: 1A1UE:L4.-'x8(o c !„Phone#: /9 3 (07 7/ Mailing Address: 3 G z_g E, 3 Z. City State Zip Code 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,ONSITE BUILT X $6.00 = • LAVS/BASINS,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 $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER j X $6.00 = • 10 ELECTRIC HOT WATER TANK _ NOTE: IF GAS,SEE MECHANICAL _ X $6.00 = 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE I X $6.00 = 'ROOF DRAINS/OVERFLOW 12 DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 = - 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = ICE AN/OR COFFEE MAKER,HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, 17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 = GREASE TRAP,SAND TRAP, 18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN _ X $6.00 = MISCELLANEOUS PLUMBING 20 FIXTUREX $6.00 = • 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = INDUSTRIAL WASTE 22 INTERCEPTOR X $15.00 = _ SUBTOTAL METHOD OF PAYMENT: 0 CASH 0 CHECK 0 VISA 0 MASTERCARD PROCESSING FEE .$35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: h 41/2 AUTHORIZED SIGNATURE: Ai L---1...- _..„-----&,-)