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2004, 09-29 Permit App: BLD-04-07805 Plumbing Reversal, Fixtures •4 001.1111\044 '" PLUMBING PERMIT APPLICATION Sfioorkane Ci€y of Spokane Valley Community Development Department BuildrngDivission Valley 11707 E.Sprague Avenue, Suite 106 „etcSpokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509)688-0037 / FOR INSPECTIONS,CALL(509)688-0054 Project Address:'— I Z ` , J k II Permit Use: Owner: )A 1 r p 6, -&-v tiJ Phone (Daytime Contact): Mailing Address: I ( 7-7- 1 D,-)(__F S/bg-rhN. Cih._ s� drod City State Zip Code Contractor. License#: Phone#: Mailing Address: . City State Zip Code #OF. TOTAL DESCRIPTION OF WORK UNITS X COST AMOUNT t TOILETS WATER CLOSET BIDETS X 56.00 = 2 URINALS 56.00 3 TUBS $6.00 4 SHOWERS(PER TRAP) BATH,STALL ON-SITE BUILT $6.00 5 SINKS LAVSIBASINS,BAR,FLOOR. KITCHEN,LAUNDRY,UTILITY, $6.00 JANITOR,PHOTO,X-RAY,FOOD, I PREP/CULINARY/MEAT 6 DISHWASHER $6.00 7 CLOTHES WASHER 56.00 111 8 GARBAGE DISPOSAL 56.00III • 9 WATER SOFTENER $6.00 10 ELECTRIC HOT WATER TANK NOTE: IF GAS;SEE MECHANICAL 56.00 El 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, © 56.00 1011.11 CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X 56.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, 1 X 56.00 II VENT, PLUMBING,REVERSAL REP R,REVERSALS 15 SEWAGE EJECTOR GRINDER, X $6.00 E 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,ANDRP.B.P.D.FOR: X $6.00 VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 II CHEMICAL HOLDING TANK 19 MEDICAL GAS iper outlet) NITROUS,OXYGEN X $6.00 III 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 I • METHOD OF PAYMENT: SUBTOTAL El CASH CHECK 0 VISA EI MASTERCARD PROCESSING FEE $35.00 DATE: • Ti EXPIRES: TOTAL PERMIT FEE DUE: — BANKCARD NUMBER: AUTHORIZED SIGNATURE: