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2005, 01-21 Permit App: 05000191 ROW, Plumbing Fixtures
4ETHOD 0 CASH Sar1� ccx)� ne Yaley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Ins,pectz.Ans, call 509-688-0054 PROJECT ADDRESS: PERMIT USE: 5-1I OWNER Agrig ty r - PHONE (Daytime Contact): ,53`9' MAILING ADDRESS: /OP N_ .iA5 42krLft,0014. (city/state) • (ZIP) (street) CONTRACTOR: Ll /_ 5 Cohst-yu_ch 0 1 1 LICENSE #: J S Col - 1a 3 k MAILING ADDRESS: PHONE #: Il �l 7 D4.,t, (street) (city/state) (LW) • PLUMBING FIXTURES )ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X $6 - �1.., SHOWERS (PER TRAP) BATH, STALL, ON -Sl r t. BUILT X $6 - - S SINKS LAVSBASINS, 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/DR4IN-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 RP.B.P.D. FOR: VATS, TANKS, BOILERS X $6 - 17 SPRINKLER SYSTEM X $25 ,- 18 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $b - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK 5:P' SUBTOTAL: PLUS PROCESSING FEE: $35.00 • ■ _ _: _.. TOTAL PERMIT FEE DUE: )ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: • Jj •1-1';4t,::,>;7,•"•: • • , .44,1440 A 4,4 '4.4 ,4444 :':ZA6 4 Sk4 •: re.• -.;3 : ,