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2004, 04-13 Permit App: BLD-04-04060 Plumbing Reversal
Spokane #valley Plumbing Permit Application 11707 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: a0 I vYI A �- 1� `•/ 4C}A// / ��/1 PERMIT USE: DETAILS # OF UNJTS J _Q` OWNER: �.. COST PHONE (Daytime Contact): .74901 [ _ (/9 5 4 `lam J Flo 9 ��(6 )31 (� n (,, MAILING ADDRESS: 111414, � Ce n/� (street) (city/state) • (ZIP) - CO �trPI(����InC URINALS LICENSE k. PHONE # PO l s X MAILING 3 C-/ /, s. d c/Gt_-nom - 3 (street) (city/state) (ZIP) PLUMBING FIXTURES METHOD OF 0 CASH DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: DESCRIPTION DETAILS # OF UNJTS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X 86 - 3 TUBS X S6 - 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 S6 - 12 FOUNTAINS, DRINKING X 56 - 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE MB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X 86 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6 - 17 SPRINKLER SYSTEM X 525 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FLXFURE X 56 PAYMENT ] CHECK ISISISIM Y15s1' moi;-- SUBTOTAL: PLUS PROCESSING FEE: $35.00 • 5,1❑ - TOTAL PERMIT FEE DUE: DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: