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2007, 11-20 Permit App 07004622 Plumbing Fixtures7'.�„[ii l Permit Center S.RS` e 11703 E Sprague Ave, Suite B-3 'S Valley Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 Community Development vww.spokanevallcv.org Plumbing Permit Application n Commercial PERMIT NUMBER: -- PERMIT FEE: Residential SITE ADDRESS: f % 6tD 3 I- 711 jj Building Owner S/�14r� /(�,,cy.� C h -c d (� 0.4 vrr� (/ Name: 5 / 4( E� �� a 6,,,,,,..(-- Phone: 2pid7 Fax: Address: /77D3 ! r /N.�SSi.),., City: fah �A9 � State: — Zip: dry Contractor Name: Phone: Fax: Address: City: State: Zip: -- License No: 6t-eAr-e--7— City Business Lic: Contact S-6 --t O + TO? Name: i ce__` 4-77e.,/ Phone: ,cdq_ 1 2 9--7 7 DESCRIPTION OF WORK 1 2 3 TOILETS URINALS TUBS 4 5 6 SHOWERS PER TRAP SINKS DISHWASHER # OF UNITS X COST TOTAL AMOUNT WATER CLOSET, BIDETS BATH, STALL, ON -SITE BUILT LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 7 CLOTHES WASHER 8 GARBAGE DISPOSAL 9 WATER SOFTENER 10 ELECTRIC WATER HEATER NOTE: IF GAS, SEE MECHANICAL 1 $6.00 $6.00 $6.00 1 $6.00 $6.00 $6.00 0 $6.00 $6.00 $6.00 $6.00 11 FLOOR DRAINS 12 ROOF DRAINS/OVERFLOW DRAINS 13 FOUNTAINS, DRINKING 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL AREA, CASE, COIL, TRENCH, CONDENSATE NSTALLATION, ALTERATION, REPAIR, REVERSALS $6.00 $6.00 $6.00 $6.00 15 16 17 SEWAGE EJECTOR WATER USING DEVICE CROSS CONNECTION DEVICE GRINDER SUMP PUMP ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS 18 GREASE TRAP, SAND TRAP, INTERCEPTORS CHEMICAL HOLDING TANK 1 $6.00 $6.00 $6.00 $6.00 19 20 MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE 21 PRIVATE SEWAGE DISPOSAL/SYS 22 INDUSTRIAL WASTE INTERCEPTOR METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# AUTHORIZED SIGNATURE: REVISED S/26/05 NITROUS. OXYGEN EXPIRES: VIN: $6.00 $6.00 $20.00 $15.00 SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: