2003, 06-20 Permit: BD03-329 Plumbing Reversal, Pipingirleasn
0{55- 9
PROJECT LJ� ,^, 11
ADDRESS: q a a s E�p,j�� V' lJ O /v
DESCRIPTION
_._—........
PERMIT
USE:
#OFUNITS
OWNER: .� LP1N I S V art
COST
PHONE (Daytime Contact): Gam- y24,0
MAILING ADDRESS:
1
Sa,P,.I e5
Jjl' ,,,, - 99a /Q
(street)
/
(cit /state) (zip)
CONTRACTOR:
N 4-3
C;onlsrk1 ctiol\J
2
LICENSE #:
N S CnN Wi- la3KF
MAILING ADDRESS:
11817g
00-y
X
$6
PHONE #:
ga- 896
,poKczyL�, Wa.
.99RO
TUBS
(street)
(city/state)
(zip)
PLUMBINGFIXTURES
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION
DETAILS
#OFUNITS
X
COST
EQUALS
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6
a
2
URINALS
X
$6
a
3
TUBS
X
56
a
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
56
a
5
--
SINKS
----
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
—
X
$6
6
DISHWASHER
X
56
a
7
CLOTHES WASHER
-
X
$6
a
8
GARBAGE DISPOSAL
X
$6
a
9
WATER SOFTENER
X
$6
a
__10
ELEC-HOT WATER TANK
NOTE: IF GAS SEE MECHANICAL
X
$6
=
11
FLOOR DRAINS
AREA, CASE, COIL,
CONDENSATE
TRENCH,
X
56
a
12
FOUNTAINS, DRINKING
X
$6
at
13
WATER PIPING/DRAIN-IN
WASTE, VENT,-
PLUMBING REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
r
X
*6
a
40.
14
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6
a
15
WATER USING DEVICE
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
56
a
16
CROSS CONNECTION
DEVICE
VACUUM BREAKER, CHECK -
VALVE, AND R.P.B.P.D. FOR:
VATS, SUMPS, TANKS, BOILERS
X
$6
a
17
SPRINKLER SYSTEM
X
$25
18 INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
-
X
56
a
19
MEDICAL GAS per outlet
NITROUS, OXYGEN
X
$6
a
20
MISC PLUMBING FIXTURE
X
$6
a
•
-
■
WILLONLY BE" ACCEPTED
OP A MAJOR CREDIT
Pxrrn cc.
SUBTOTAL
440
■
CASH • CHECK ❑
-- ----PAXED PERMITS
-
PLUS PROCESSING---
FEE
-
DATE:
'WITH PAYbCEM
CARD
-
$35.00
TOTAL PERMIT FEE
DUE
jp 0 0
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
4 -120 - 0 7` ` 111/