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2003, 08-12 Permit App: BLD-03-02206 Plumbing Fixtures
4ETHOD OF ] CASH Spokane�"` #Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, -WA1/499206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT // 4.71-- ��/ S PERMIT USE: fir/ i � ' C OWNERADDRES OWNER/ l# 1Q COST PHONE (Daytime Contact): l7ay p g+ S MARIN ADDRnESS: Seg/11 -e 1 (street) (city/state) (ZIP) CONTRACTOR �, O [l /Y' lAi'nJe J LICENSE #: /f / 2 (,se? C C`r✓ !'r fr1.V. .-.� r6S f MAILING ADDRESS: �� I..),"r.,---4, / 9 ?/ c S,n 1 r•.��.JAc: -c 5 c'49 ?TWA PHONE #: 9" pa'/- .5"-Y FS ran,"/ s/y E.1.5,97,!� -,14,:i....) (street) (city/state) (ZIP) PLUMBING FIXTURES /ATE: EXPIRES: ANKCARD NUMBER UTHORIZED SIGNATURE: 3i -SO DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS / X $6 - (a ,Qv 2 URINALS X $6 - /' . 00 3 TUBS X $6 - 4= 4 SHOWERS (PER TRAP) BATH, STALL, ON -SPIE BUILT / X $6 - a),(00 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 E6 - 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 - 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X M - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FLCIURE X $6 - PAYMENT CHECK man___......... VIM !Izsf± .-�..: SUBTOTAL: / gr F, PLUS PROCESSING FEE: $35.00 • • TOTAL PERMIT FEE DUE: /ATE: EXPIRES: ANKCARD NUMBER UTHORIZED SIGNATURE: 3i -SO