2004, 08-06 Permit App: BLD-04-07275 Plumbing Reversal, Fixturesl
n PLUMBING PERMIT APPLICATION
SGT„„Ale City of Spokane Valley Community Development Department
IPN„1 /��� BuildingDivision alley 3 ' X 707 E. SpragueAvenue, Suite06
Spokane;
36; neF Valley, ) WA
6 9900237
•
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: //r/ S 67 /74 x cec// %C,. Permit Use:
Owner: C,' 3 Ceti ha !r; Phone (Daytime Contact):
Mailing Address: —5/gni 1”
Contractor:(;,,,,- Lg. ks,
Mailing Address:
City State Zip Code
License #:cC,r,,rg/7Y4 Phone #: 97'1 Sv �S
City
State
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
5,400
Zip Code
DESCRIPTION OF WORK
# OF
UNITS
X
COST
=
TOTAL
AMOUNT//
1
TOILETS
WATER CLOSET, BIDETS
./X
$600
=
4 . m0
2
URINALS
X
$6.00
3
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
$8.00
=
5
SINKS
LAVSBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
/
X
$6.00
=
4 00
6
DISHWASHER
X
$8.00
=
7
CLOTHES WASHER
X
$6.00
8
GARBAGE DISPOSAL
X
$8.00
=
9
WATER SOFTENER
X
$8.00
=
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
$6.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
$8.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$8.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
/
X
$6.00
=
/J�
Y 1 ®r%
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
$6.00
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
$6.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR.
VATS, TANKS, BOILERS
X
$6.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$6.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
$6.00
=
METHOD OF PAYMENT:
❑ CASH 0 CHECK ❑ VISA 0 MASTERCARD
DATE: EXPIRES:
SUBTOTAL
18.°0
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
!
(+1f j'TSb
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
5,400
Zip Code