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2006, 01-24 Permit App 06000206 Plumbing Fixtures
Permit Center Spo`"kane 11707 E Sprague Ave, Suite 106 4.01000Vailey Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development www.,spokanevalley.ora.com Plumbing Permit Application D Commercial %' Residential SITE ADDRESS: / L/ - V /-- �r i-/tea PERMIT NUMBER: �a;)--0 (0 PERMIT FEE: Building owner . p<- f •• g (n /o r Name: �f�; �--/- 5:Q ✓ / %/G Phone Fax: Address: City. State: Zip: . Contractor �/ --- ,r /7 . Name: Phone: 9 f / _ E6 . 5 -/ Fax: Address: /Q ` .- 7 �, /�,/,._) City : State: Zip: License No: City Business License No: Contact 'I;: .. Name: Phone: D DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS f X $6.00 = C% v j 2 URINALS X $6.00 = , 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH. STALL. ON -SITE BUILT / X $6.00 = C 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN. LAUNDRY. UTILITY, JANITOR, PHOTO, X-RAY. FOOD. PREP/CULINARY MEAT 3 X $6.00 = , � •C / ?, 00 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.0D = 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 = 4, C V 11 FLOOR DRAINS AREA. CASE. COIL TRENCH, CONDENSATE & X $6.00 = / J 0 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 PROOFER. CARBONATOR. SWAMP COOLER 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 (per outlet) NITROUS. OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X $15.00 = , METHOD OF PAYMENT: �( CASH ❑ CHECK J4 Card# 7 SUBTOTAL Ziff c Q 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 ) EXPIRES: TOTAL PERMIT FEE DUE: /7.68' 3, 0(3 AUTHORIZED SIGNATURE REVISED Sr26/OS