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2007, 05-04 Permit App 07001598 Plumbing FixturesSpone Valley Community Development Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.org Plumbing permit Application ❑ Commercial PERMIT NUMBER: /7( 5 PERMIT FEE: Residential SITE ADDRESS: c Ina");\ 7? _ Building Owner Name: Phone: Fax: Address: `� City: State: Zip:LA) Contractor Name: L LirPhone: Fax: Address: .---5—Al 6A C X,,),vZ `,,c,CA?) ieri City: ' Ci `��o `fix State: �J4_ Zip:q c, License No: 0 . 1 per; 8 / City Business Lic: i72 J z-/ e J Contact ; tl %-^7c' , IAA r Name: Phone: so `7...... ,,,,7,3 _ ..,,,,,,7 `j ,.,--t, DESCRIPTION OF WORK # OF UNITS COST 1 TOILETS WATER CLOSET, BIDETS 1 $6.00 2 URINALS $6.00 3 TUBS $6.00 4 5 6 SHOWERS PER TRAP SINKS DISHWASHER BATH. STALL, ON -SITE BUILT LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT 2 0 X $6.00 $6.00 $6.00 7 CLOTHES WASHER $6.00 8 GARBAGE DISPOSAL $6.00 9 WATER SOFTENER $6.00 10 ELECTRIC HOT WATER TANK 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 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 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK 1 $6.00 $6.00 $6.00 $6.00 TOTAL AMOUNT 19 20 MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE NITROUS, OXYGEN $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: