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2003, 08-06 Permit App: BLD-03-02160 Plumbing Reversal
S((m�art<.x 11707 East Sprague Avanue,Suite 106 509-688-0036-Phone pO .Ile Spokane Valley,'WA 99206 509-688-0037-Fax Walley For Inspections, call 509-688-0054 Plumbing Permit Application PROJECT PERMIT ADDRESS: i 1 1 3 I'` t Ct /4 " USE: OWNER: L i,l n 1 t // .e. PHONE(Daytime Contact): L $/ ! 3 MAILING ADDRESS: t 1 -3 L2 Ludo o 1--.= 64) bor►L-4 q -or Ca (street) (city/state) (ZIP) COTe J `-'LR.V mai° /I t/Ji 4,\ i 1 LICENSE#: MAILING ADDRESS: PHONE#: 3 c 1 /D S. dcfm_int... S g3 I - 5q I 3 ,*0-P\a,(s. 10 cc_ q 9 6 3 ' --7 (street) (city/state) (ZIP) ' PLUMBING FIXTURES 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 LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 - RAY,FOOD,PREP/CULINARY/MEAT 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 INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING. REVERSALS X $6 REVERSAL 1 14 SEWAGE EJELIOR GRINDER,SUMP PUMP X $6 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB, _ STEAMER,PROOFER,CARBONATOR, X $6 - SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND RP.B.P.D.FOR:VATS,TANKS,BOILERS X $6 17 SPRINKLER SYSTEM 18 INTERCEPTORS X $25 GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 = 19 MEDICAL GAS per outlet NITROUS,OXYGEN 20 MISC.PLUMBING FIXTURE X $6 - X $6 THOD OF PAYMENT SUBTOTAL: iiiiilli =rte,:, VISr , Crest ; ASH ❑ CHECK 0 0 's.`::-".."-'. PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: E: EXPIRES: KCARD NUMBER: 3ORIZED SIGNATURE: