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2008, 10-02 Permit App 08003916 Washerspokan e Valley Community Development Plumbing Permit Application El Commercial Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permi tcenter(aspokancvall ey.org PERMIT NUMBER: �9 ( PERMIT FEE: Residential SITE ADDRESS: / 6 3 se,5 A f 4 >' i9 Lic_ Building Owner ' T ' Ir., V y Name: Lit, ft1t1 : J� n, S .</3 j f3Q 41 3' 2>, Avehone: Fax: Address: �. City: State: ,.40.s f- 23/?nA�7e.,,,q i 4 U L �',Pn:ce/to cl.piv4', t�C> 4 Zip: `}I� /e, .2a Contractor Phone: Fax: Name: Lt 5 rc:c1 Ay PALs7nnirLiz5 Address: "< Kf./ City. -SAIICl}/L{ OA/kV State: E%t i9 Zip: 9 9/3/: License No: /J? 5: i 1N A /© e% 4, Ai 17 City Business Lic: Contact ��77 �� �7 Name: ff:!r% 7�%p 0/1 .c�L'UL'1 one: q2 "..39 7 % ,— 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 SHOWERS (PER TRAP) SINKS 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 DISHWASHER $6.00 7 CLOTHES WASHER $6.00 8 GARBAGE DISPOSAL $6.00 9 WATER SOFTENER $6.00 10 ELECTRIC WATER HEATER 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 SEWAGE EJECTOR GRINDER. SUMP PUMP $6.00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER $6.00 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS $6.00 18 INTERCEPTORS GREASE TRAP. SAND TRAP, CHEMICAL HOLDING TANK $6.00 19 20 MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE NITROUS. OXYGEN $6.00 $6.00 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 22 INDUSTRIAL WASTE INTERCEPTOR $15.00 METHOD OF PAYMENT: ❑CASH ❑ CHECK 0 VISA 0 MC Card# AUTHORIZED SIGNATURE: REVISED 8/26/05 EXPIRES: VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: