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2003, 12-08 Permit App: BLD-03-03215 Plumbing Reversal¶OD OF SH Sar"kane Valley 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: ci,pa. ‘'.1 ..., / 3 fr DETAILS PERM USE: X COST OWNER: izAze'09 0 g AMOUNT PHONE (Daytime Contact): 93 (., -0 / 3 MAILING ADDRESS: 7 1-P- '4?-- --/q • AP -L 1 .1— _I Ad .i.:.....i I $6 - 0 (street) (dty state) _ (ZIP) X $6 . 3 TUBS LICENSE#: X LING ADDRESS: 3 e_i / D _S , 4o 0-1<cycst aiint_s uct_ SHOWERS (PER TRAP) PHONE it: qc:D. 1 _ 5 / 56 qq,(5, 5 SINKS (street) (city/state) (ZIP) 56 - • PLUMBING FIXTURES :AM NUMBER: )RIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 . 3 TUBS X 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE MALT X 56 - 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X 56 - 6 DISHWASHER X $6 - 7 CLOTHES WASHER X 56 .. • 8 GARBAGE DISPOSAL X 56 .. 9 WATER SOFTENER X $6 - 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL , X 56 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X 56 - 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL IN III .'ft -5N w TION, REPAIR, : ''''' X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X 56 ,- 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR VATS, TANKS, BOILERS X . . 17 SPRINKLER SYSTEM X $25 .. 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 56 . 19 MEDICAL GAS per outlet NITROUS, OXYGEN X 56 •, 20 MISC. PLUMBING FDC11./RE X 56 - PAYMENT 3 CHECK • /54- * _ ..., - ..E.,---,-%!. a.,ast; — SLTBTOTAL: PLUS PROCESSING FEE: $35.00 0 sL ...._.......___ TOTAL PERMIT FEE DUE: . W. (fp :AM NUMBER: )RIZED SIGNATURE: