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2003, 11-10 Permit App: BLD-03-03037 Plumbing ReversalTHOD O :ASH a74 cx ...„ Spo1ne ,r,,, `Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 Phone Spokane Valley, WA 99206 509-688-0037 - Fax PROJECT ADDRESS: /1 f 5of DESCRIPTION +71 PERMIT USE: X COST EQUALS AMOUNT OWNER: /4//e. `" WATER CLOSET, BIDETS PHONE (Daytime Contact): X - / MAILING ADDRESS: 5I4'r✓1 �( URINALS 4' " $6 - (street) 3 (city/state) • (ZIP) X $6 CONTRACTOR: -. -- �� LICENSE t: BATH, STALL ON-SITE BUILT X $6 / .40 MAILING ADDRESS:PHONE SINKS // ' - ars #: X ' $6 - �easi -1 DISHWASHER X (street) - (city/state (Gll')• 7 CLOTHES WASHER PLUMBING FIXTURES IKCARD NUMBER: HORIZED SIGNATURE:. DESCRIPTION DETAILS # OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS (PER TRAP) BATH, STALL ON-SITE BUILT X $6 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UITLITY, 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 $6 - 12 FOUNTAINS, DRINKING - _ . _ _-- __ __ __ _ _ _ . .. X $6 — 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS / X $6 - 6 ; OO 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 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 TANK X $6 - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT ' 'Pta.stli. CHECK ❑ 1111111111111 SUBTOTAL: PLUS PROCESSING FEE $35.00 TOTAL PERMIT FEE DUE: e/l` er, 0 IKCARD NUMBER: HORIZED SIGNATURE:.