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2004, 02-04 Permit App: BLD-04-03502 Plumbing FixturesMETHOD 0 0 CASH S16ne 000%alley 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 PROJECT ADDRESS: /3 Z ( %/'e., PERMIT USE: DETAILS OWNER: j2 ,_A--1/ 61, , + t, / `� ,_A--1/�j PHONE (Daytime Contact): COST MAILING ADDRESS:✓I l ( / ( '0l/'/(i,IC c c v-Y'j (-z. i AMOUNT (street) (city/stat (ZIP) TOILETS CONTRACTOR: '"e--,-)-7 C � /dis,�l! LICENSE #: �,` � (� c, �� MAILING ADDRESS: -302." t l 1/ ,9 579r; 4, PHONE #: 2 /- evS--v - --- �s „ URINALS (street) (city/state) (ZIP) PLUMBING FIXTURES DATE: EXPIRES: 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 a X $6 = 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT 1/ 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, 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 1 CHECK VISA' . mase?- SUBTOTAL: PLUS PROCESSING FEE: $35.00 • • I - - - TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: