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2004, 06-07 Permit App: BLD-04-04497 Plumbing ReversalMETHOD OF CASH DATE: Okarie .Malley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For In'spections, call 509-688-0054 PROJECT i PERMIT USE: DETAILS 41..../L, 0 R: , 0/ 4 , 174 ,, mi.A0APHONE (Daytime Contact): MAILIN A DP -//5-- c -2T Zezkiii/Lki %. Y4(-6)6YYD-OZ7 (street) (city/state) (ZIP) cors„A_Eff: p _ P I (i.4-yutvi A LICENSE #: MAILING ADDRESS: 3// S. d cfctiit PHONE #: q01-3-7/ 2 (street) (city/state) (ZIP) PLUMBING FIXTURES BANKCARD NUMBER.: AUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X .. 2 URINALS X $6 - 3 TUBS X $$ - 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 - 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X - 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 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X - 12 FOUNTAINS, DRINKING X - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6 •• 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE 51B, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X = 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 $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X PAYMENT ..._ .. • - .,---,-_ DC.HECK El .___ .,..7.,::•ii.'-' -„--- SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DLTE: BANKCARD NUMBER.: AUTHORIZED SIGNATURE: