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2004, 02-18 Permit App: BLD-04-03577 Plumbing Reversal
METHOD OF 0 CASH S okane .0001sgalley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Vakey, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PROJECT ADDRESS:9(/ 6 01/ g- //44,/ k, // PERMIT USE: OWNER: / cai:i/�A nn/Pl PHONE (Daytime Contact): /r __cif es `� MAILING ADDRESSS: C4rw/ (street) (city/state) (ZIP) CONTRACTOR:r /R G/- fA, 6 LICENSE #: MAILING ADDRESS: / 78/ 8 C �° Cr 'nw-r,es PHONE I: 5'a2 �/eSt/�S (L/2I 9 - o / 6 (street) (city/state) (ZIP) PLUMBING FIXTURES DATE' EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE' DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILE IS 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 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.BP.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 MEM MA. CHECK 0 =EOM ' A - ^ — SUBTOTAL: W PLUS PROCESSING FEE: $35.00 _ TOTAL PERMIT FEE DUE: 6 / DATE' EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE'