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: