2006, 11-14 Permit App 06004507 Wood StoveSPooka e
jValley
Community Development
MC -C :antral Permit
Permit center D
11707 E Sprzgue Ave, Sui 0
Spokane Valley, WA 9920
(509)688-0036 FAX: (509)¢8 O
E, C LE F1 W E LD)
7 NOV '4 2006 n
PERMIT NUMBER: L� 0
PERMIT FEE:
Building Owner
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Name:
Phone:5 _ 7 _�
Far.:
Address:
Sou
City: G
State: Zip:
Contractor
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Name:
Phone:
Fax:
Address:
City:
State: Zip:
License No:
City Business Lie:
Contact' ...
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Name:
Phone:....
AUTHORIZED SIGNATURE:
REVISED 9/26/05
Spokane
®Valley
Community Development
Permit Center
11707 E Sprague Ave, Suite 106
Spokane Valley, WA 99206
(509)688-0036 FAX: (509)688-0037
www. sp ok an e v al l e v. or e
Plumbing Permit Application
PERMIT NUMBER:
PERMIT FEE:
❑ Commercial ❑ Residential
SITE ADDRESS:
Building Owner
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
Contractor
Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
COST
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
$6.00
2
URINALS
$6.00
3
TUBS
$6.00
4
5
6
SHOWERS PER TRAP
SINKS
DISHWASHER
BATH, STALL. ON -SITE BUILT
LAVS/BASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
$6.00
$6.00
$6.00
0
7
CLOTHES WASHER
$6.00
8
GARBAGE DISPOSAL
$6.00
9
WATER SOFTENER
$6.00
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS. SEE MECHANICAL
$6.00
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
$6.00
12
ROOF DRAINS/OVERFLOW DRAINS
$6.00
13
FOUNTAINS, DRINKING
$6.00
14
WATER PIPING/DRAIN-IN WASTE,
VENT. PLUMBING. REVERSAL
NSTALLATION, ALTERATION, REPAIR,
REVERSALS
$6.00
15
16
17
18
19
20
21
22
SEWAGE EJECTOR
WATER USING DEVICE
CROSS CONNECTION DEVICE
INTERCEPTORS
MEDICAL GAS (per outlet)
MISCELLANEOUS PLUMBING FIXTURE
PRIVATE SEWAGE DISPOSAUSYS
INDUSTRIAL WASTE INTERCEPTOR
METHOD OF PAYMENT:
CASH ❑ CHECK 0 VISA 0 MC
Card#
GRINDER, SUMP PUMP
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP
COOLER
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, TANKS,
BOILERS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
NITROUS. OXYGEN
EXPIRES:
VIN:
$6.00
$6.00
$6.00
$6.00
$6.00
$6.00
$20.00
$15.00
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE:
1
AUTHORIZED SIGNATURE:
REVISED S/26/05