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2003, 07-24 Permit App: BLD-03-02071 Plumbing ReversalMETHOD OF 0 CASH Spokane Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane?:Ta11ey;•WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT ADDRESS' (5--1, f, /0 Li 1 C �, J`�Z PERMIT USE: DETAILS OWNER: C2! S.- ,^ eye: /� � X PHONE (Daytime Contact): MAILING ADDRESS: AMOUNT (Street) (city/state) (ZIP) TOILETS CONTRACTOR: / .,, #/t C` �/�r12/� ay.",// LICENSE #: nn )i>rcet /IC/ -'//e 7 MAILING ADDRESS: / 9737$ Adn. 3/fit c- e_. PHONE it: 52 9 - y,757..5-90 7 2 URINALS (street) (city/state) (ZIP) ' 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- 6. ,o0 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 $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT ] CHECK I--_ :gid.::": Pif'esfd. L _ _ SUBTOTAL: �' et; PLUS PROCESSING FEE: $35.00 YEA ❑ -° :" ❑ TOTAL PERMIT FEE DUE: y(, O0 DATE: EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: