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2003, 08-04 Permit: BLD-03-02138 Plumbing Reversal['HOD 0 :ASH *Wane �an iUey Plumbing Permit Application 11707 East SnragL-e Avenue, Suite 106 509-688-0036 - Phone 509-688-0037 - Fax Spokane Valley, WA 99206 PROJECT ADDRESS: O A ,,,£ . � PERMIT USE: OWNER: t� .5",..,j ���v ri Aj PHONE (Daytime Contact):r7�._ 72/7 +f MAILING ADDRESS: S09 --m -e ' 7 WATER CLOSET, BIDETS -I LU/A-, (street) $6 - (city/state) (ZIP) CONTRACTOR / �� _ f,- LICENSE #:,,--..ti/'CG t ' /F/ A? 7 MAILING ADDRESS: i ? Fl i Es _510r/9-, to /19 A PHONE #: —P._ gay ^ , -t1/Zs . r?',04/ A (street) X $6 (city/state) (Gil') PLUMBING FIXTURES E. EXPIRES: KCARD NUMBER: FIORIZED 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 LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO; X- RAY, FOOD, PREP/CULINARY/MEAT X $6 - 6 DISHWASHER X $6 - 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 11 FLOOR DRAINS AREA, CASE,.COIL, TRENCH, CONDENSATE Ir. $6 - 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS / X $6 - ,- C'b 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, 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 $b •. 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - . 20 MISC. PLUMBING FIXTURE X $6 - 7 PAYMENT r 4. VISA'PJ1 SUBTOTAL: /' c c� PLUS PROCESSING FEE: $35.00 III III■ r_.._ s:: TOTAL PERMIT FEE DUE: 'f 1, cd E. EXPIRES: KCARD NUMBER: FIORIZED SIGNATURE: