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2004, 03-02 Permit App: BLD-04-03656 Sprinkler System
Spokane .000 -Valley Plumbing Permit Application L11707 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: Oo4 Ni /��� G ccc;,,,,:j /e0,/USE: 7 PERMIT OWNER: E'O/,‘i, JA 4 pxx„. PHONE (Daytime Contact): MAILING ADDRESS: 7‘' ,v . G; ,-,, etc' ,...x ,6! d.4',/,1 1 /(1;"k ta-e . ice,/�-7j"-3r (street) (city/state) CONTRACTOR: si* / 74. LICENSE #: $6 MAILING ADDRESS: PHONE #: URINALS X (street) (city/state) (ZIP) . PLUMBING FIXTURES METHOD OF 0 CASH 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, 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 I X $6 - �' 60 li - "1_ _V-14"NC'TS.o: 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 VISA f as 6. - SUBTOTAL: PLUS PROCESSING FEE: $35.00 • NM= ■:_._._.._.__.... TOTAL PERMIT FEE DUE: /// METHOD OF 0 CASH DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: