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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: