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2007, 11-07 Permit App 07004465 Plumbing Fixtures
Si l ane valley Community Development Permit Center 11703 E Sprague Ave, Suite B-3 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevallev.org Plumbing Permit Application ❑ Commercial PERMIT NUMBER: Liu PERMIT FEE: I t/Residential SITE ADDRESS: �(72L/ E - Building Owner ^ /A //Ic / l/ / ! !f ) // 'l/JI !, S 1 •. k, Name: �I 4C--1 �Y vJ Cl.k`� Phone: S 6 C Fax: Address: / ,'''C J )S, ` / / _ 'v ^ City: / J( % 06, State: j / A Zip: 9, !o.ri Contractor Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: 1 DESCRIPTION OF WORK TOILETS WATER CLOSET, BIDETS # OF UNITS COST TOTAL AMOUNT $6.00 2 URINALS $6.00 3 TUBS $6.00 4 5 6 SHOWERS PER TRAP SINKS DISHWASHER BATH. STALL, ON -SITE BUILT LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD. PREP/CULINARY MEAT 0 $6.00 $6.00 $6.00 0 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 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 18 19 20 21 22 SEWAGE EJECTOR WATER USING DEVICE CROSS CONNECTION DEVICE INTERCEPTORS MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE PRIVATE SEWAGE DISPOSAUSYS INDUSTRIAL WASTE INTERCEPTOR METHOD OF PAYMENT: ❑CASH ❑ CHECK ❑ VISA ❑ MC Card# AUTHORIZED SIGNATURE: REVISED 8/26/05 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 GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK NITROUS, OXYGEN EXPIRES: VIN: 0 $6.00 $6.00 $6.00 $6.00 $6.00 $6.00 $20.00 $15.00 SUBTOTAL PROCESSING FEE 0