Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2003, 09-10 Permit App: BLD-03-02428 Plumbing Fixtures
METHOD 0 pd CASH DATE: *Wane .,,Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509 -688 -0037 -Fax PROJECT ADDRESS: / % � N 52,4-5,-E PERMIT USE: # OF UNITS OWNER: /�Lf'/�75 ty,, sly et PHONE (Daytime Contact): 9c�/ _ 4/6 3 -7 MAILING ADDRESS /a /e it/- 5a5/ r �de%.,C ( 952"? WATER CLOSET, BIDETS (street) (city/state) (ZIP) $6 CONTRACTOR: LICENSE #: URINALS MAILING ADDRESS: AA PHONE #: $6 - (street) (city/state) (ZIP) PLUMBING FIXTURES BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION - DETAILS # OF UNITS X COST EQUALS MUN AOT 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 LS.VSBASINS, 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 $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 $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, MOCHA,CARBONATOR, SWAMP COOLER _ X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND RP.B.P.D. FOR: VATS, TANKS, BOILERS X - 17 SPRINKLER SYSTEM X 825 - 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 Y/S4 Mils. .. SUBTOTAL: PLUS PROCESSING FEE: $35.00 • ■ '-- --^- TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: