HomeMy WebLinkAbout2005, 11-14 Permit App: 05004299 Plumbing Fixtures.r
Permit Center
p
Okaile 11707 E Sprague Ave, Suite 106
jValley Spokane Valley, WA 99206 A PERMIT NUMBER:
(509)688-0036 FAX: (509)688-0037 '� PERMIT FEE:
Community Development www.spokanevalley.org.com
Plumbing Permit/ Application El Commercial ❑'Residential
SITE ADDRESS:/ ESS: _ S 7 / X /=-' ;Z S ✓ T
Building owner
DESCRIPTION OF WORK
Name:
Phone: F2L' % /7 —16 L2 Fax:
Address:
City: State: Zip:
Contractor
TOTAL AMOUNT
Name:
Phone: Fax:
Address: % / / -ZaLzCity
f
License No:
City siness License No:
Contact
Name: V
Phone:
AUTHORIZED SIGNATURE:
REVISED M&05
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
-
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 1
$6.00
=
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
=
22
INDUSTRIALWASTE
INTERCEPTOR
X
$15.00
=
METHOD OF PAYMENT:
/,CHECK
El CASH a CHECK [I VISA El MASTERCARD
Card# EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED M&05