2007, 09-25 Permit App 07003799 Plumbing Fixtures' Permit Center
Spokane•I { 11703 E Sprague Ave, Suite B-3 PERMIT NUMBER: '
Spokane Valley, WA 99206
ww.
�,jValleyw w 88-0036 FAX: (509)688-0037
ww.spokanevalley.ors? PERMIT FEE:
Community Development
Plumbing Permit Application ❑ Commercial [Residential
SITE ADDRESS:
U41
Building Owner
DESCRIPTION OF WORK
Name:
Phone:
Fax:
Address: Iv, , 67/0 G' JW r
C
City. O , v
State: L4-F%—Zip:
Contractor ` L
i 1
L. e
✓T
Name:
Phone:
ax:
Address: 3 /a�
7
City. 15,001,14&YState:
Ute. Zip:
License No:
City Business Lic:
X
Contact
=
Name: iGf
Phone: 5'oC '_
DESCRIPTION OF WORK
# OFUNITSX
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
✓T
X
$6.00
-
co
2
URINALS
X
$6.00
=
3
TUBS
X
$6.00
-
4
SHOWERS PER TRAP
BATH, STALL, ON-SITE BUILT
if
X
$6.00
=
00
5
SINKS
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
/
X
$6.00
=
• D0
X-RAY, FOOD, PREP/CULINARY MEAT
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
$6.00
=
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
X
$6.00
=
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
17
CROSS CONNECTION DEVICE
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 DISPOSAL/SYS
X
$20.00
=
22
INDUSTRIAL WASTE INTERCEPTOR
X
$15.00
-
SUBTOTAL
METHOD OF PAYMENT:
FEE MC EXPIRES: $35.00
[]CASH[ICHECK ElVISA El MC
Card# VIN: TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE:
REVISED 8/26/05