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2004, 09-15 Permit App: BLD-04-07654 Plumbing ReversalProject Address: F ,60(u) Owner: 727.af Miff Mailing Address: Contractor 6,P I Mailing Address: PLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, .WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Permit Use: , Phone (Daytime Contact): qe,')cp- (7‘7ge. 4 - BANKCARD NUMBER. AUTHORIZED SIGNATURE: DESCRIPTION OF WORK *OF UNITS - X COST ' • TOTAL. AMOUNT 1 TOILETS WATER CLOSET, BIDETS X . *6.00 *6.00 . ., 2 URINALS - X 3 TUBS X *6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $8.00 INKS LAVS/BASINS, BAR, FLOOR, CHEM, LAUNDRY, UTILITY, JAKtTQR PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT X *6.00 = . DISHWASHER *6.00 CLOTHES WASHER X WOO6 - GARBAGE DISPOSAL X $6.00 9 WATER SOFTENER X $6.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL i X $6.00 $6.00 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS, DRINKING X $6.00 4 WATER PIPING/DRAI -I A ... TE, VENT, PLUMBIN ,- EVER • INSTALLATION, ALTERATION, REPAIR REVERSALS X $6.00 SEWAGE EJECTO GRINDER, SUMP PUMP X *6.00 *6.00 WATER USING DEVICE ICE AN/OR COFFEE MAKER HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK ' ' VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X *6.00 INT1 ERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X *6.00 = 19 MEDICAL GAS (per outlet) MISCELLANEOUS PLUMBING FIXTURE NITROUS, OXYGEN X X *6.00 $6.00 - = • 20 METHOD OF PAYMENT: 0 CASH 0 CHECK 0 VISA 0 MASTERCARD DATE EXP(RES: SUBTOTAL PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: 4//- in) BANKCARD NUMBER. AUTHORIZED SIGNATURE: