2006, 07-19 Permit App: 06002783 Plumbing Fixtures Permit Center
Spokane 11707 E Sprague Ave,Suite 106
4.0f Valley Spokane Valley,WA 99206 PERMIT NUMBER: 7 3
(509)688-0036 FAX:(509)688-0037 PERMIT FEE: 7t-5/
Community Development www.spokanevalley.om
Plumbing Permit Application n Commercial n Residential
SITE ADDRESS: 6 70 3 /^_ I + 7f SPO)4 t/(f ?/ LIY'7 . 9gzJ ?—
Building
Building Owner y^ ) ki_ S U—7
Name: S d e Phone:91 ?v 5 b i 3Fax:
Address: h ]11 ' / f City: <i State: Zip:
Contractor / L —ut /lYz, wl P 0 t.0 nl e eName: l 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 =
LAYS/BASINS,BAR,FLOOR,KITCHEN,
5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, ``� X $6.00 =
X-RAY,FOOD,PREP/CULINARY MEAT ✓
6 DISHWASHER 1 X $6.00 =
7 CLOTHES WASHER , X $6.00 =
8 GARBAGE DISPOSAL X $6.00 =
9 WATER SOFTENER I X $6.00 =
10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL I- 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 CHECK ❑VISA ❑MC EXPIRES: $35.00
Card# VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05