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2004, 04-30 Permit App: BLD-04-04236 Plumbing Reversal
METHOD 0 ❑ CASH DATE: Spokane Dalley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 ibte PROJECT ((( ��'��-�/ A,„ ADDRESS 9o/ / /�. S 1 ULt PERMIT USE: DETAILS OWNER: ! / i 0 // t ain 5, p r 6C I((�// / Y PHONE (Daytime Contact): COST /1 MAILING ADDRESS: Y 90(LW.8,Ago S AetAD 7, _9 6 ,a5igek (street) (city/state) (ZEE') TOILETS CO R int % n ��P �aQ �l(� LICENSE #: $6 MAILING ADDRESS: C 3L%/a S.daio PHONE !1: P0/-3-7/ . URINALS (street) (city/state) (ZIP) $6 PLUMBING FIXTURES BANKCARD NUMBER. AUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X - COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 - 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X $6 - 6 DISHWASHER . X $6 - 7 CLOTHES WASHER X $6 - 8 GARBAGE DISPOSAL X $6 - 9 WATER SOFTENER X 86 - 10 ELECT HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6 - 12 FOUNTAINS, DRINKING X $6 - 73 WATER PIVENT, WASTE, VENT, PLUMBING PLUMBING REVERSAL INR, ALTERATION, REPAIR, EVERSAiS / X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, SIEAMER,PROOFER,CARBONATOR, SWAMP COOLER X $6 16 CROSS CONNECTION DEVICE VACUUM BREAKER CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6 - 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X _ - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK YISA teas 'we �_"^X'>.:,:._ SUBTOTAL: PLUS PROCESSING FEE: $35.00 ■ ■ TOTAL PERMIT FEE DUE: C :) ft BANKCARD NUMBER. AUTHORIZED SIGNATURE: