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2008, 12-02 Permit App 08004668 Wtr Htr
valley Stiorkarte Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 permitcenter@a spokanevalley.ore Plumbing Permit Application PERMIT NUMBER: PERMIT FEE: ❑ Commercial cgResidential SITE ADDRESS: Building Owner i Name: /V`'64- S.;La �y n /P7 Phone: 9.z, ,_ &i.7/ Fax: Address: /o< 7 611 -55-` o i'.l City: S'ODKCI.? e✓( /C (4›, State: (4.2/9"-- Zip: g 9.2/6' Contractor Name: rI� � \ �O KU y�Cl �� (�s � Iv4� �Jd✓l ''{ Phone: �± Fax: 7�/�Sa� Address: S�.zo N E lfv y. Cfi �J City: State: Spo,e-Q„ e W,,, Zip: 9Q..?/Z License No: 500k A F i ad 3z_ City Business Lic: ye S Contact Name: �,.0 Phone: 9-' _034/6 DESCRIPTION OF WORK # OF UNITS COST TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 2 URINALS X $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 er 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $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 X X $6.00 $6.00 21 PRIVATE SEWAGE DISPOSAUSYS $20.00 22 INDUSTRIAL WASTE INTERCEPTOR $15.00 METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# AUTHORIZED SIGNATURE: REVISED 8/26/05 EXPIRES: VIN: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: