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2006, 10-09 Permit App: 06004032 Plumbing Fixtures dr Permit Center "T'"` 117G7 E Sprague Ave,Suite 106 s„jVall PERMIT NUMBER: ,:.--103 Spokane Valley,WA 99206 (509)688-0036 FAX:(509)688-0037 PERMIT FEE: *Z-l Community Development www.spokanevallev.ore Plumbing Permit Application E] Commercial IIIResidential © g SITE ADDRESS: / ! ) 7 6 l g F6 Building Owner �,412,k Ci- pt4 (., Name: Phone: Fax: 1��J2R C�E3�'1 ��;Aw ��7c� '/33aI Address: 9 I`� la IA City: :7 p J< V 4 L l-.fi ' State: A_ Zip: 99 D.43 b Contractor,n/\,2,\< 'C,L r p c2 il. c. OW 10.6Q. 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 Qt? X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT 1 X $6.00 = LAYS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT t 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 't X $6.00 = AREA,CASE,COIL,TRENCH, , 11 FLOOR DRAINS CONDENSATE r 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 r� COOLER off. 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 WASH 0 CHECK 0 VISA ❑MC EXPIRES: $35.00 Card# VIN: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05