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2004, 08-11 Permit App: BLD-04-07357 Plumbing Reversal, Fixtures , d. PLUMBING PERMIT APPLICATION Sökane - C';•• of Spokane ,ffey Community DevelopmentDepartment -> >' ���� BuildingDivision 11707 E. Sprague Avenue, Suite 106 „,,,, �p! Spokane Valley, WA 99206 1�"� � � - .one: (509)688-0036;Fax: (509)688-0037 �' FOR INSPECTIONS, CALL(509)688-0054 Project Address: .o' / "(7 'ermit Use: Owner: , e •e Iir Phone (Daytime Contact): Mailing Address: 34✓1 -( City State Zip Code Contractor: . _ o . . /. ,, icense#:07-4eryfgx7 Phone#: 5 9- V-6i Mailing Address: j? S'l k" E ._. .0,,,„-4,5 r, +m ey,) cry 1:///52- 9 P046 City State Zip Code #OF - TOTAL DESCRIPTION OF WORK UNITS X COST = AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6.00 = 60 a E1n 2 URINALS _ X ; $6.00 = 3 TUBS /! _X $6.00 , = f/ 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = ( . r0 5 SINKS LAVSIBASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD, / � PREP/CULINARY/MEAT CcI. 'n 6 DISHWASHER _X $6.00 = 7 CLOTHES WASHER X _ $6.00 = 8 GARBAGE DISPOSALX $6.00 = 9 WATER SOFTENER X $6.00 _ 10 ELECTRIC HOT WATER TANK NOTE IF GAS,SEE MECHANICAL ,X $6.00 = 11 FLOOR DRAINS AREA,CASE,COIL TRENCH, X $6.00 = CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 ,_ 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS / //> •/0 e ) 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X $6.00 = CARBONATOR,SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR: X $6.00 = VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $8.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X - $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = ,/ • METHOD OF PAYMENT: SUBTOTAL a 4 0 CASH ❑ CHECK ❑ VISA ❑ MASTERCARD PROCESSING FEE $35.00 5 � � DATE: EXPIRES: TOTAL PERMIT FEE DUE: ,, ie) BANKCARD NUMBER: AUTHORIZED SIGNATURE: