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2004, 09-03 Permit App BLD-04-07559 Plumbing FixturesSpokan' ems' #Valley PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Project Address: ,E. J# 40 7 d r au.11.-an Owner: /ic.,4 A Cr. r e, A Mailing Address: Contractor. Permit Use: S�tc-r Phone (Daytime Contact): City S}te Zip Code 7" � � hone #' a2 / � �G� Jed-, Co, 7 <— License #: GG✓1 EE6 Mailing Address: 1�� ,'v cvli%, /o city —< 9�6 State ZipCode DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 = 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON -SITE BUILT X $6.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, X $6.00 = PREP/CULINARY/MEAT 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK X $6.00 = NOTE IF GAS, SEE MECHANICAL 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 PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, REPAIR. REVERSALS / X $6.00 _ 0 o �- 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.PD. FOR VATS, TANKS, BOILERS X 86.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $too 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK j3k4ISA 0 MASTERCARD DATE EXPIRES: SUBTOTAL O° b - PROCESSING FEE $35.00 TOTAL. PERMIT FEE DUE: 4t1 BANKCARD NUMBER: AUTHORIZED SIGNATURE: