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2004, 07-15 Permit App: BLD-04-07076 Plumbing Reversal
METHOD 0 ❑ CASH DATE: Spokane°' coolValley 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 fi 7!"4",,e, ADDRESS: QC -_7%} '1 PERMIT USE: DETAILS OWNER: I 'aru, %, a i_O>4 l/n/ PHONE (Daytime Contact): COST MAILING ADDRESS: C /% % /� %�) ,c- ,G/oa (l ( /1! tli° �,pl,0// % - c�J (street) (city/state) • (ZIP) c9 CO gQRR: (P Ii�un 1 no LICENSE it: X MAILING ADDRESS ( 3c-//S.dc'an PHONE r: PO i _ S q 2 URINALS (street) (city/state) (ZIP) PLUMBING FIXTURES BANKCARD NUMBER: AUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF LIMITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X S6 - 2 URINALS X $6 - 3 TUBS X $6 - 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 - 6 DISHWASHER X c,J6 - . 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 S6 - 12 FOUNTAINS, DRINKING X $6 - 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 BB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X $6 - 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 $6• PAYMENT ] CHECK aila VIS4- 1IGSsf•. — SUBTOTAL: PLUS PROCESSING FEE: $35.00 ■ 411=21 • TOTAL PERMIT FEE DUE: Gl/' BANKCARD NUMBER: AUTHORIZED SIGNATURE: