2014, 09-12 Permit App: BLD-2014-2183 Plumbing FixturesPermitcux Project -2oey Zts3
7� n'e_ 11707 E SPRgue Ave, Suite 106
Spokane Valley, WA 99206 MR 1 !sw°Y__ k'- M
(509)6884)076 FAX: (509)69341(137 +
Cotmwnity Development vrnw s0okanevallcv ore com - ?Y{
Plumbing Permit Application In Commercial W Residential
SITE ADDRESS
CSV PER^dIT
CENTER
X
COST
LAM
TOTAOUNT
1
TOILETS
Name: D7 04
Phone L
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Address:
Cory State
Zi
2
ww
Name: Gold $eal
Phone: Fax:
sam
Address:
City Stale
Zi
License No:
City Business License No:
X
.W
Name: es t
Phone: 2I 'd - t-192
SHOWERS ERTRAP
AUTHORIZED SIGNATURE: aavlsrn ysyaa
DESCRIPTIONOFWORK
SOF/UNITS
X
COST
LAM
TOTAOUNT
1
TOILETS
WATERCLOSET BIDETS
t0
%
.00
-
�6
2
URINALS
X
sam
3
TUBS
X
.W
Zy
6
SHOWERS ERTRAP
BATH, STALL, ON-SITE BUILT
X
Sam
-
5
SINKS
LAVSIBASINS, BAR FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
XRAY FOOD, PREPKXILINARY MEAT
X
$6.w
il0
6
DISWASHER
N.w
T
CLOTHES WASHER
Z
X
.00
IZ
8
GARBAGE DISPOSAL
X
Sam
e
WATER SOFTENER
X
56.00
-
10
ELECTRICHOTWATERTANK
NOTE IF GAS SEE MECHANICAL
X
11
FLOOR DRAINS
AR CASE COI TRENCH CONDENSATE
X
Ss.w
-
12
ROOFDRAINS+OVERPLOW
DRAINS
X
Sam
-
13
FOUNTAINS DRNKING
X
66.00
16
WATER PIPING,DRAN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTAIATION, ALTERATION, REPAIR
REVERSALS
-
15
SEWAGE EJECTOR
GMNDER. SUMP PUMP
X
$6.w
-
16
WATER USING DEVICE
ICE MOOR COFFEE MAKER HOBE BIB,
STEAMER
PROOFER CaFtBONKTOK SWAMP COOLER
y
X
50.00
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR VATS TM1KS,BOILERS
X
SagoGREASETRAP,SANDTRAP,INTERCEPTORS
CHEMICAL HOLDING TANK
X
50.00MEDICALGAS
rou5at
NRROUS OXYGEN
X
ss.wMISCELLANEOUS
[17
PLUMBING
FLKTUREPRIVATE
SEWAGE OISPOSAUSYS%A.W
__INDUSTRIALWASTE
INTERCEPTOR
x
6,5.00
-
! 5 ro
METHOD OF PAYMENT:
I7 CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE E)(PIRES:
SUBTOTAL
PROCESS ING-FEE
535.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: aavlsrn ysyaa