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2006, 06-14 Permit App: 06002301 Plumbing Fixtures S aoKane 11707 E Sprague.Ave,Suite 106 PERI�11 I NUMBER: �� ®Valley Spokane Valley,WA 99206 (509)688-0036 FAX:(509)65B-0037 / t" j .?. PERMIT FEE: - Com-Dunity Development ww.svokanevallev.ors ' x� - 'Plumbing Permit Application [1Commercial Residential SITE ADDRESS: 176 .2 Z /� /C/) = 4 Building Owner / Name: b // Phone: 1 / ✓� rre�� �r ✓ 41 ,--.1 c ✓ �i _ ‘, C/S-J Fax: Address: 7G 2 - / v r! City: S State:z_..._....) .¢— Zip: , ,, az Contractor . Name: Phone: Fax: Address: City State: Zip: License No: City Business Lic: Contact Name: Phone: 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 = LAVSBASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = a' 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 X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL X $6.00 = AREA CASE,COIL,TRENCH, 11 FLOOR DRAINS - CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW 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, AND R.P.B.P.D.FOR: VATS,TANKS, 17 CROSS CONNECTION DEVICE 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 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAL/SYS X_ $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE ['CASH O CHECK 0 VISA 0 MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8126/05