2004, 09-14 Permit App: BLD-04-07650 Plumbing Reversala
S� lane
Malley
Project Address:
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Owner. ?l cur
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Mailing Address: ( t1% (_o CEJ'} Zai
Contractor. a
Mailing Address: Fri P j -I
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildlngDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS,�_CALL (509) 688-0054
(
Permit Use: `&"K
Phone (Daytime Contact):
(Low( Cult 900
City State Zip Code
License #:C'earc2 %J f Phone #: Q
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:NJt'
Zip Code
-- 0 7 Co CO
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
$6.00
=
2
URINALS
X
$6.00
=
3
TUBS
X
56.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$6.00
=
5
SINKS
LAVS/BASINS, BAR, FLOOR
KITCHEN, LAUNDRY, UTILITY,
JANITOR. PHOTO, X-RAY, FOOD.
PREP/CULINARY/MEAT
X
$6.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
$6.00
=
8
GARBAGE DISPOSAL
X
$8.00
9
WATER SOFTENER
-
X
5600
=
40
ELECTRIC HOT WATER TANK•
NOTE IF GAS SEE MECHANICAL
X
$6.00
=
"
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$6.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
S6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION.
REPAIR, REVERSALS/�('
` f
1
X
$6.00
=
/� -QC\
�[
15
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,-
AKERHOSE BIB, STEAMER, PROOFER,
HOSE
CARBONATOR SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK
VALVE, AND RPS.P.D. FOR
VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
CASH [] CHECK ❑ VISA 0 MASTERCARD
DATE EXPIRES:
SUBTOTAL
(3'15)
PROCESSING FEE
$35.0'V
0\'^
TOTAL PERMIT FEE DUE:
V
(-4) •
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:NJt'
Zip Code
-- 0 7 Co CO