Loading...
2005, 05-06 Permit App: 05001456 Plumbing ReversalPLUMBING PERMIT APPLICATION Phone: (509) 688-0036; FAX: (509) 688-0037 For Inspections, CaII (509) 688-0054 Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Project Address: �dsi., m�- / 'O /� Permit Use: Owner. .t2 _ / S „co..., Phone (Daytime Contact): Mailing Address: /E. ,A,s__",a A—/30 /f T O£a.-e AV, Q9�-/e4 ‘en 6a—lc- /94, -,Ac- City State Zip Code Contractor ner.-„llJ recA✓al./7:•-, License#: Phone#: OD_7-g/S-P-7 Mailing Address: t.. /D ?6 ? /5.- 1 city L4 �C State Zip Code BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION OF WORK # OF UNITS X COST . = TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6.00 = 2 URINALS X $6.00 = 3 TUBS X $6.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X 36.00 = 5- SINKS IAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT' X $6.00 = 6 DISHWASHER - X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X 36.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 36.00 = 11 FLOOR DRAINS AREA, CASE, COIL TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X 36.00 = 13 FOUNTAINS, DRINKING X 36.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALIATION, ALTERATION, REPAIR, REVERSALS / X 36.00 = 4116 ` Q9--- 15 SEWAGE EJECTOR GRINDER. SUMP PUMP X 36.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $6.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 36.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X 320.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X 315.00 = METHOD OF PAYMENT:- 0 CASH CHECK DATE T-- 0 VISA 0 MASTERCARD SUBTOTAL ��_ 6. PROCESSING FEE 335.00 EXPIRES: TOTAL PERMIT FEE DUE: 4/..9------ BANKCARD NUMBER: AUTHORIZED SIGNATURE: