2014, 09-12 Permit App BLD-2014-2180 Plumbing FixturesPertnit Center —Pr 0J e c t #JZ
�'. n_ e _ 11707 E Sprague Ave, Suite 106
�c y Spokane Valley, WA 99206
rdilE'� (509)688-0036 FAX: (509)688-0037
Community Development www spolanevallev.ore.com
Plumbine Permit Application ❑ Commercial W esidential
SITE ADDRESS
T CENTER
,------- '1
AUTHORIZED SIGNATURE: aEv1SED WW5
DESCRIPTION OF WORK#OF
UNITS
X
Name:
Phone:
TOTALAMOUNT
1
TOILETS
Address:
/
t0
Ci
State
Zi
Contractor
Name: Got() $QG
sr
Phone:-
URINALS
Fax:
3•�".'E"
Address:
$0.00
City
State
Zi
License No:
Citv Business License No:
X
$8.00
-
Z1i
4
SHOWERS PER TRAP
BATH, STALL, ONSITE BUILT
Name: AtA
Phone:
Z I
-
AUTHORIZED SIGNATURE: aEv1SED WW5
DESCRIPTION OF WORK#OF
UNITS
X
COST
-
TOTALAMOUNT
1
TOILETS
- WATER CLOSET BIDETS
/
t0
X
$6.00
-
36
2
URINALS
X
$0.00
-
3
TUBS
X
$8.00
-
Z1i
4
SHOWERS PER TRAP
BATH, STALL, ONSITE BUILT
X
$8.00
-
5
SINKS
LAVSBASINS, BAR, FLOOR KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
$6.60
=
y 8
6
DISHWASHER
Z
X
$6.00
7
CLOTHES WASHER
-
L
X
$6.00
-
2
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 PIPINGIDRAIN-IN WASTE,
VENT, PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6.00
-
15
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
$6.00
-
18
WATER USING DEVICE -
ICE ANIOR COFFEE MAKER HOSE BIB,
STEAMER
PROOFER CARBONATOR, SWAMP COOLER
Lq
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 (par outlet)
NITROUS OXYGEN
X
$6.00
-
20
MISCELLANEOUS PLUMBING
FIXTURE
X
$6.00
-
21
PRIVATE SEWAGE DISPOSAUSYS
X
$20.00
-
22 1
INDUSTRIAL WASTE
INTERCEPTOR
I
X 1
$15.00
METHOD OF PAYMENT:
❑ CASH ❑ CHECK ❑ VISA ❑ MASTERCARD
DATE: EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
AUTHORIZED SIGNATURE: aEv1SED WW5