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2003, 07-21 Permit App: BD-03-818 Plumbing Fixtures['HOD 0 :ASH E: SOT N1]ane .00.0Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax PROTECT - ADDRESS: 7s`- JC, /C. r `�i ,t» PERMIT n n USE V N -- 03- �� i OWNER: //<!! .)/ /�C vii "-re/i e PHONE (Daytime Contact): X MAILINGA DRESS: E 5,9-m -e EQUALS (street) (city/state) (ZIP) 1 CONTRACTOR-�,,G,� CoRc/4,r,uIo Cs ae.L e%hutJLICENSEA,7Qtu/CC II:( /y/ /2? MAILING ADDRESS: ' /Y E Sror.9-5 CI P Lei PHONE #: / 0/A 2 (street) (city/state) (LIP) PLUMBING FIXTURES KCARD NUMBER: .3ORJZED SIGNATURE: pQO� �csS � DESCRIPTION DETAILS 4 OF UNITS- X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS / �� + 2 URINALS . X $ _ ` C f 3 TUBS X $6 - 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 7 $6- 49OO 5 SINKS - LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO; X- RAY, FOOD, PREP/CULINARY/MEAT / X $6 - 4. 6 DISHWASHER X $6 - fin 7 CLOTHES WASHER - X $6 - B 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 __—_____. 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 AP.B.P.D. FOR: VATS, TANKS, BOILERS X $6 - 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 CHECK a -— SUBTOTAL: 077- PLUS PROCESSING FEE: $35.00 • =WM ■ AXPTRR9 TOTAL PERMIT FEE DUE: 5Yeer KCARD NUMBER: .3ORJZED SIGNATURE: pQO� �csS �