2004, 12-06 Permit App: 04009328 Plumbing ReversalProject Addres
Owner:
PLUMBING PERMIT APPLICATION
>,.s
Phone: (509) 688-0036; FA)(: (509) 688-0
For Inspections, Cali (509) 688-0054
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Phone
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Mailing Address: /0//1 F wc-yL nac
Contractor
Mailing Address:
nity Development Department
Building Division
707 E. Sprague Avenue, Suite 106
°Lc Spokar�U� y, WW�,- X8206
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to
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City State Zip Code
License #:
one
City
State
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
R OF UNITS
X
COST
=
TOTAL AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56 00
=
2
URINALS
X
$6 00
=
3
TUBS
X
56.00
4
SHOWERS (PER TRAP)
BATH STALL, ON-SITE BUILT
X
56 00
5
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD, PREP/CULINARY MEAT
X
56.00
6
DISHWASHER
X
5600
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
56 00
=
9
WATER SOFTENER
X
56.00
10
ELECTRIC HOT WATER TANK
NOTE: IF GAS, SEE MECHANICAL
X
56.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6 00
=
12
ROOF DRAINS/OVERFLOW
DRAINS
X
56.00
13
FOUNTAINS. DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
NSTALLAT 7ALTEFREPAIR,
( REVERSALS
/1
1
X
56.00
=
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Ly/ - tJO
15
SEWAGE EJECTOR
GRIITNNiDDDEEER'SUMP PUMP
X
5600
=
16
WATER USING DEVICE
ICE AN/OR COFFEE MAKER, HOSE BIB,
STEAMER
PROOFER, CARBONATOR, SWAMP COOLER
X
56 00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE,
AND R,P.B.P D FOR: VATS, TANKS, BOILERS
X
56 00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56 00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56 00
=
20
MISCELLANEOUS PLUMBING
FIXTURE
X
5600
21
PRIVATE SEWAGE DISPOSAL/SYS
X
520 00
=
22
INDUSTRIAL WASTE
INTERCEPTOR
X
51500
=
METHOD OF PAYMENT:
❑ CASH ❑ CHECK 0 VISA 0 MASTERCARD
DATE EXPIRES:
SUBTOTAL
A' VI� O
`
PROCESSING FEE
$35.0001
TOTAL PERMIT FEE DUE:
//
`tel 1' ( / 0
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: