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2006, 09-21 Permit App: 06003798 Plumbing Fixtures SAO'Kane 11707E Sprague Ave,Suite 1D5 ���j fey Spokane Valley,WA 99206 PERMIT NUMBER: 0(D31 (509)688-0036 FAX:(509)688-0037 Community Development wccw.svolcanevalley.ora ` 'it. PERMIT r EE: : ;. . PIumbing Permit Application ❑ ~�Commercial _ id sential SITE ADDRESS: / /v r(�& �-! 7 c�ILQ,tr (,/'Id(/ S A ( (,4)1� . Building Owner •�- �/ �/l I t...4)2 )'tc,` . . Ph. . . . Name: :. .... one: Fax: Address: City. State: Zip: Contractor Pi Name: ? 1 one /�'k Roc-ter er It IYI.i lid,y, `i- Ph . 07 `77.2-,3iar/ Fa':: Address: ✓ City: '/ State: Zip: _� /��/tfe'� � , /y�7; i>r.v .4111: 1'txl�[b �T'�li ��J�. �JQ'.�5� License No: � City Business Lic: /�Ir-K.Li(>f la.5...-T, C� Contact - _ Name: MA 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 X $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL ONSITE BUILT j X $6.00 = L, LAVS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = X-RAY,FOOD,PREP/CULINARY MEAT ( c 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 = 1 i FLOOR DRAINS AREA,CASE,COIL TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.DD = 13 FOUNTAINS,DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION,ALTERATION,REPAIR, = 14 VENT,PLUMBING,REVERSAL REVERSALS X $6.00 6, - 15 r, --- 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, 16 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 DISPOSAL/SYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = SUBTOTAL METHa 9 • OF PAYMENT: let,•"-t.•_, , PROCESSING FEE %s a SH HECK 0 VISA 0 MC EXPIRES: $35.90 !/ Card# VIN: TOTAL PERMIT FEE DUE: -�/+cc V AUTHORIZED SIGNATURE: REVISED 5126/05