2004, 10-28 Permit App: BLD-04-08055 Plumbing Reversal{ETHOD 0
] CASH
S Okane
. Valley
Plumbing Permit Application
11707 East Sp -agog Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
PROJECT 61:22‘-'€,S
ADDRESSNL -D-a- X ‘-€s
DESCRIPTION
PERMIT
USE:
0 OF UNITS
OWNER 1,` %u
e1nAL\
sAkzk„Q
cvI
PHONE (Daytime Contact): (3_P _ (
`coo [o
t 5
MAILING ADDRESS:
0 • i4.)-3. okSe
(street)
(city/state)
X
(ZIP)
-
/
CONTRACTOR: L( S
/
Coh s,t rIt ch 013
URINALS
LICENSE s:
/L) 3 C 0 { i
'�j
I,R-3 k /J
MAILING ADDRESS:
-
PHONE #:
9.4 --
X
$6
(street)
(city/state)
4
(ZIP) .
BATH, STALL, ON -51 -TE BUILT
PLUMBING FIXTURES
r
DESCRIPTION
DETAILS
0 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 -51 -TE BUILT
X
$6
5
SINKS
LAVSTBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
56
-
7
CLOTHES WASH ER
X
$6
-
8
GARBAGE DISPOSAL
X
$6
-
9
WATER SOFTENER
X
$6
-
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
56
-
13
WATER PIPING/DRAIN-1N
WAS1E,VENT, PLUMBING.
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
`
X
$6
-
/
I(-0
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
-
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CIIECK VALVE, AND
RP.B.P.D, FOR: VATS, TANKS, BOILERS
X
86
-
I7
SPRINKLER SYSTEM
X
$25
-
18
I.NTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
-
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT•
— - :
VISA'• Veit; , - ,;
'r7-,-.527
] CHECK ❑ ❑ -- -=:
SUBTOTAL:
f fi
l n - O
V
PLUS PROCESSING FEE:
$35.00
TOTAL
TOTAL PERMIT FEE DUE:
4! ' (\
)ATE: EXPIRES:
ANKCARD NUMBER
UTHORIZED SIGNATURE: