2004, 05-10 Permit App: BLD-04-04307 Plumbing ReversalSpokane
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: :I a 0 LI E. 0 cored do
l J
PERMIT
USE:
DETAILS
# OF UNITS
X
OWNER: s few ^ �-,J L -
b(rU [l �yyl� a
PHONE (Daytime Contact):
AMOUNT
1
(rJ l 7
9'-1 (t q
MAILING ADDRESS: /
n' ( E OL(
D
X
$6
(strIeD state) (ZEE')
2
URINALS
CO�1'pR. L V' I (k,n h1 -9 I nC
'ADDDRESSS:: t .�J �
LICENSE k:
$6
-
MAILING / 1
3C// S.detob n�
TUBS
PHONE II: •-
(,O( i
5
/
$6
-
4
SHOWERS (PER TRAP)
(street) (city/state) (ZIP)
X
$6
PLUMBING FIXTURES
METHOD OF
0 CASH
ll�
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
# OF UNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
-
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, UTILY, JANITOR, PHOTO, X-
F
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
-
6
DISHWASHER
X
$6
- •
7
CLOTHES WASHER .
-
X
S6
-
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/DRAIN-IN
WASTE, VENT, PLUMBING.
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
)(
$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
$6
- -.
17
SPRINKLER SYSTEM
X
$25 -
-
18
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
-
X
- .
19
MEDICAL GAS per outlet '
NITROUS, OXYGEN
X
$6
-
20
MISC. PLUMBING FIXTURE
X
$6
-
PAYMENT
CHECK
illiiai
!k'rq•.
',
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00 •
• ■
.
TOTAL PERMIT FEE DUE:
DATE: EXPIRES:
BANKCARD NUMBER
AUTHORIZED SIGNATURE: