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2007, 10-10 Permit App 07004056 Plumbing Fixtures
Spo�kane� ��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 FEE: Residential SITE ADDRESS: O Building Owner(NA,�7r� r (14.1.- Name: Phone:,;.; ti, ,q :. 11 7 7 Fax: Address: i1 .. 1 ,� jekiA6 City: ",0� . (, 4 - State: Zip: 4(72_f Contractor t Name: Phone: Fax: Address: City: State: Zip: License No: City Business Lic: Contact Name: Phone: DESCRIPTION OF WORK # OF UNITS X COST = TOTAL AMOUNT TOILETS WATER CLOSET. BIDETS $6.00 (12 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 7 CLOTHES WASHER 2— O $6.00 $6.00 $6.00 O $6.00 8 GARBAGE DISPOSAL X $6.00 9 WATER SOFTENER X $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 15 16 17 WATER PIPING/DRAIN-IN WASTE, _ VENT, PLUMBING, REVERSAL SEWAGE EJECTOR WATER USING DEVICE CROSS CONNECTION DEVICE NSTALLATION, ALTERATION, REPAIR, REVERSALS 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 1 $6.00 $6.00 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 TOTAL PERMIT FEE DUE: