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2004, 08-16 Permit App: BLD-04-07377 Plumbing ReversalMETHOD 0 ❑ CASH Spokane 4:000Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, W.A. 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 -X5 7 PROJECT 7� ADDRESS: 1 I X Q, Cl k1 /L �/,) jn_ �7 a PERMIT USE: 11 OF UNITS OWNER: / •, LGLI.I g V 'j7 / ni //� / 1 C�ttY��f//���(((�"--(J PHONE (Daytime Contact): 9_, c� 9 —�V �1 MAILING ADD ESS: 11 B r� C% f. L.0 Mbliod - 14,Lyxo (,0q9c9-0 r (street) (city/state) (ZIP) X atgtA197 f(✓� -VI ;> I u-i1t I AC LICENSE #: URINALS MAILING ADDRESS 3 c/ la S. C ciebrit X PHONE #: (101-57/3 - (street) (city/state) (ZIP) PLUMBING FIXTURES DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE. DESCRIPTION DETAILS 11 OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 11355 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 86 - 8 GARBAGE DISPOSAL X $6 - 9 WATERSOFTENER 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 r- REVERSAL INSTALLATION, ALTERATION, REPAIR, r— REVERSALS . ,� � _____-"'� ' X $6 - iii / O, (if 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 4 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 TAMC X 56 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT ] CHECK VIS �.. &tis ,; '---...-- .. SUBTOTAL: PLUS PROCESSING FEE: $35.00 • =MOO❑ TOTAL PERMIT FEE DUE: C// a DATE: EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE.