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2004, 05-11 Permit App: BLD-04-04324 Plumbing ReversalMETHOD 0 0 CASH *Wane ck� S .ne .00 %Hey Plumbing Permit Application 11707 East Spra.ie Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT ADDRESS: iQ(l L.... .,`-- DESCRIPTION PERMIT IT USE: # OF UNITS X COST OWNER: 1.1 0-1(1 fit.../y) r rt AMOUNT PHONE (Daytime Contact): n I ✓t - WATER CLOSET, BIDETS MAILING ADDRESa t o I. (- lr L j ) � r 1( '(Q LOA- q 7o (street) (city/state) (ZIP) CO AsEQR: 6 0L, p p / bt�n it)1 nC $6 LICENSE #: 3 TUBS MAILING ADDRESS: 3 c/ /, S, d clo PHONE #: . C/ ' S 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT (street) (city/state) (ZIP) , 5 PLUMBING FIXTURES 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 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 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 X $6 - 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 $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK Masi .. ^ ; SUBTOTAL: PLUS PROCESSING FEE: $35.00 II■ `_ _'.' TOTAL PERMIT FEE DUE �%/... J(') DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: