2007-06-04 Permit App 07002078 ShowerPermit Center
S` " ne 11707 E Sprague Ave, Suite 106
Valley Spokane Valley, WA 99206 PERMIT NUMBER��"
(509)688-0036 FAX:(509)688-0037
Community Development www.spokanevallev.ora PERMIT FEE:
Plumbing Permit Application ❑ Commercial 2Residential �
SITE ADDRESS: %`fir 2 / / k-, /-/ i1 dG' C ,
Building Owner
DESCRIPTION OF WORK
Name: r
Phone:
7ii� Fax:
Address:
City:
5/°� State: Zip:
Contractor
WATER CLOSET, BIDETS
t
Name: C'G r� ,� 6 r t% `
Phone:
, .2 if3 0 Fax:
Address: i GjG 5, r r 1 f
City:
State: t1 1 Zip: �2 '70e e -r
License No:
City Business Lic:
Contact
$6.00
=
Name: t'/ i �ve-e %
Phone:
1/;V4'
AUTHORIZED SIGNATURE:
REVISED 8126105
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
-}
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.00
=
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
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
-
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
-
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
-
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
-
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
X
$6.00
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
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
1 $15.00
-
METHOD OF PAYMENT:
[]CASH ❑ CHECK ❑ VISAMC EXPIRES:
Card# VIN:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
.OI 4 f
AUTHORIZED SIGNATURE:
REVISED 8126105