2007, 11-14 Permit App: 07004554 Plumbing Fixtures I.
Permit Center
sone 11703E Sprague Ave,Suite B-3
�'�Valley Spokane Valley,WA 99206 PERMIT NUMBER: C6
(509)688-0036 FAX:(509)688-0037 PERMIT FEE:
Community Development www.spokanevallev.or,
Plumbing Permit Application n Commercial ❑ Residential
SITE ADDRESS: I Z 50 E . 7 '/ l po La,vil k \i Ci QQ c-c., ( LC A `19 7 U.r,
Building Owner
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Name: AVL S�- oZ- Ig-
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Contractor7CL ''LS , f 4i6� eQ V x-�t'L.C
Name:C �'�C51 Phone: Fax:a0&_ 7 73- GZ '
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Address: City: i ),0 State: T_AD Zip: 3 k , /
License No: V P [. Lo 59 35c__lCity Business Lic: j
Contact 0 0__c ,Th
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Name: Phone: 9Q _ s(Cf .....(:c6&>---1
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DESCRIPTION OF WORK #OF UNITS X J COST = TOTAL AMOUNT
1 TOILETS WATER CLOSET,BIDETS X $6.00 =
s.2 URINALS X $6.00 =
3 TUBS I X $6.00 =
4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I 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 X $6.00 =
7 CLOTHES WASHER X $6.00 =
8 GARBAGE DISPOSAL X $6.00 =
9 WATER SOFTENER X $6.00 =
10 ELECTRIC WATER HEATER NOTE: IF GAS,SEE MECHANICAL 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 DISPOSAL/SYS X $20.00 , =
22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 =
SUBTOTAL
METHOD OF PAYMENT:
PROCESSING FEE
❑CASH 0 CHECK NJ/VISA 0 MC EXPIRES: $35.00
Card# Ix` VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: n
REVISED 8/26/05