2009, 05-13 Permit App 09001339 Plumbing Fixtures(535
Permit Center
Spokane 11703 E Sprague Ave, Suite B-3
Valley Spokane V alley, W A 99206
�i (509)688-0036 FAX: (509)688-0037
Community Development www.spokanevallev.ore
Plumbing Permit Application n Commercial n Residential
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SITE ADDRESS:
PERMIT NUMBER
PERMIT FEE:
Building Owner
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Name:
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Fax:
Address: —
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City:
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Zip:
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Contractor
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Name:
Phone:
Fax:
Address:
City:
State:
Zip:
License No:
City Business Lic:
Contact
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Name:
Phone:
DESCRIPTION OF WORK
# OF UNITS
X
COST
TOTAL AMOUNT
1
2
TOILETS
URINALS
WATER CLOSET, BIDETS
X
X
$6.00
$6.00
3
TUBS
X
$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
X
$6.00 =
$6.00
I
II
X
$6.00
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$6.00 =
9
WATER SOFTENER
X
$6.00
10
ELECTRIC WATER HEATER
NOTE: IF GAS, SEE MECHANICAL
X
$6.00 =
11
12
13
14
FLOOR DRAINS
ROOF DRAINS/OVERFLOW DRAINS
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
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
AREA, CASE, COIL, TRENCH,
CONDENSATE
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
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
NITROUS, OXYGEN
EXPIRES:
VIN:
X
X
$6.00
$6.00
$6.00
$6.00
X
X
X
X
$6.00
$6.00
Moo
$6.00
$6.00
$6.00
$20.00
0
$15.00 =
SUBTOTAL
PROCESSING FEE
TOTAL PERMIT FEE DUE: