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2003, 12-01 Permit App: BLD-03-03169 Plumbing Reversal,001;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 03 -37 1-9 PROJECT // ,� ADDRESS: / 3 0 / Li }- /n,' ,, 'ITh D I%, / l A� / C� ( PERMIT USE: OWNER: 0,a ...„4_"'Y!! J '1—k PHONE (Daytime Contact): MAILING ADDRESS: (.1 / aoIcl f,- 4i4)--PQg o kilyvt, Q(t 9.7,5(-). (street)(city/state) (city/ststate) (ZIP) COT -WILT AMOUNT / i R /7_4'F ' 7 ika. LICENSE #: 0r) MAILING ADDRESS; 3 L/ /D S- 01< 5 13ct_ PHONE k: (c) 1 -59 / 3 �j 9915.'7 (street) (city/state) (ZIP) 2 URINALS PLUMBIN 8 GARBAGE DISPOSAL 9 WATER SOFTENER 10 ELECT. HOT WATER TANK 11 FLOOR DRAINS 12 FOUNTAINS, DRINKING NOTE: IF GAS, SEE MECHANICAL AREA, CASE, COIL, TRENCH, CONDENSATE 13 WATER PIPING/DRAIN-IN INSTALLATION, ALTERATION, REPAIR, WASTE, VENT, PLUMBING. REVERSALS REVERSAL 14 SEWAGE EJECTOR GRINDER, SUMP PUMP 15 WATER USING DEVICE 16 CROSS CONNECTION DEVICE 17 SPRINKLER SYSTEM 8 INTERCEPTORS ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, X 36 SWAMP COOLER $6 X $6 X $6 X $6 X $6 _ X $6 X (J X VACUUM BREAKER, CHECK VALVE, AND RP.B.P.D. FOR VATS, TANKS, BOILERS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK IOD OF PAYMENT SH 0 CHECK 0WSW ran :ARD NUMBER: EXPIRES: IRIZED SIGNATURE: X $6 X $25 X $6 X $6 SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 2 URINALS X 56 3 TUBS X - $6 4 5 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6 - SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD, PREP/CULINARY/MEAT X 56 6 DISHWASHER X $6 - 7 CLOTHES WASHER 8 GARBAGE DISPOSAL 9 WATER SOFTENER 10 ELECT. HOT WATER TANK 11 FLOOR DRAINS 12 FOUNTAINS, DRINKING NOTE: IF GAS, SEE MECHANICAL AREA, CASE, COIL, TRENCH, CONDENSATE 13 WATER PIPING/DRAIN-IN INSTALLATION, ALTERATION, REPAIR, WASTE, VENT, PLUMBING. REVERSALS REVERSAL 14 SEWAGE EJECTOR GRINDER, SUMP PUMP 15 WATER USING DEVICE 16 CROSS CONNECTION DEVICE 17 SPRINKLER SYSTEM 8 INTERCEPTORS ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, X 36 SWAMP COOLER $6 X $6 X $6 X $6 X $6 _ X $6 X (J X VACUUM BREAKER, CHECK VALVE, AND RP.B.P.D. FOR VATS, TANKS, BOILERS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK IOD OF PAYMENT SH 0 CHECK 0WSW ran :ARD NUMBER: EXPIRES: IRIZED SIGNATURE: X $6 X $25 X $6 X $6 SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: