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2006, 03-08 Permit App 06000726 Plumbing Fixturesrerrrut ):enter C 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX:(509)688-0037 Community Development ce.ww snokanevafley.or, .com Plumbing Permit Application ❑ Commercial Residential SITE ADDRESS: q5 / 6 45 (---13.( Bnilding owner S®4- 4 { %, C (&—) Name: Phone: Fax: p� Address: —16/ q E 620;—1,1t,rly City. State: Zip: Contractor . /4-L4„✓1I .fix G4•4vA-I, 11 '. _ Name: kI/li 4. t- etg t Phone: 2.,-S/— e J Jr)) Fax: Address: `-6J 2.-j yU 11 p,d_ City : 5 State: ,--,.(- Zip: / 7 License No: of City Business License No: .-'5-2 Contact ; Name: Phone: 1 2 3 5 6 7 8 9 10 11 12 DESCRIPTION OF WORK it OF UNITS X COST = TOTAL AMOUNT TOILETS WATER CLOSET, BIDETS P X $6.00 = URINALS X $6.00 = TUBS j X $6.00 = - SHOWERS (PER TRAP) BATH. STALL, ON -SITE BUILT X $6.00 SINKS LAVS/BASINS, BAR. FLOOR, KITCHEN. LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD. PREP/CULINARY MEAT X $6.00 = = DISHWASHER / X $6.00 = CLOTHES WASHER X $6.00 = GARBAGE DISPOSAL X $6.00 = WATER SOFTENER X $6.00 = ANK FLOOR DRAINS ROOF DRAINS/OVERFLOW DRAINS NOTE IF GAS. SEE MECHANICAL AREA CASE, COIL TRENCH, CONDENSATE 13 14 15 16 17 18 FOUNTAINS, DRINKING WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL SEWAGE EJECTOR WATER USING DEVICE CROSS CONNECTION DEVICE INTERCEPTORS NSTALLATION, ALTERATION, REPAIR, REVERSALS 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 $6.DO $6.00 $6.00 $6.D0 $6.00 $6.0D $6.00 $6.00 19 20 MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE 21 22 PRIVATE SEWAGE DISPOSA SSYS INDUSTRIAL WASTE INTERCEPTOR METHOD OF PAYMENT: ❑ CASH Card# D CHECK AUTHORIZED SIGNATURE: NITROUS, OXYGEN $6.00 $6.00 $6.00 $20.00 $15.00 ❑ VISA ❑ MASTERCARD EXPIRES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: REVISED 626/05