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2007, 09-27 Permit App: 07003847 Plumbing Fixtures Permit Center \Cl S�,n 11703E Sprague Ave,Suite B-3 PERMIT NUMBER: pokane Spokane Valley,WA 99206 (509)688-0036 FAX:(509)688-0037 PERMIT FEE: 40.00Valley www.spokanevalley.org Community Development Plumbing Permit Application n Commercial,, !! ❑ Residential SITE ADDRESS: /200 f. JPoeAA)F 1/A LLc , 1414 1"gz4, Building Owner(/✓ A E.-. ,�/ //„u-sJ^Cd Name: !'>,A/tfi/rl F- 41/1-t Phone: Phone:: /1b0 '02!s k2/7 Fax: /� Address: !�D c /sic 6 City:Ji�G' f1NL- VA(.(G-) State:141A Zip:7 9,2I$ Contractor -54 171 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 I X $6.00 = 2 URINALS X $6.00 = 3 TUBS J X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = LAVS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT 2 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 DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE ❑CASH 0 CHECK .VISA 0 MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05