2003, Permit: BD03-416 Plumbing Fixture art it `were, 68
11707 East Sprague Avenue,Suite 106 509- 8-0036-Phone
. S .ne Spokane Valley,WA 99206 509-688-0037-Fax
4.00Valley
Plumbing Permit Application J Z p - gf‘
PROJECT PERMIT
ADDRESS: X36O g. Shatc--zP USE:
OWNER: PHONE(Daytime Contact):
MAILING ADDRESS:
(street) (city/state) (ZIP)
CONTRACTOR: (10ri - LICENSE#:
f)J0Q13.heffi/7)-(9MAILING ADDRESS: PHONE#: _s) e5- _ /\
/ Cil / g-. ap20,,L t. ..._.,
street (city/state)) ci( ry/ ) (ZIP) 9se.r(f..A
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,DRINKI G X $6 -
1 • R PIPING IN-I t STALLATION,ALTERATION,REPAIR,
WASTE,VENT,PLUMBING •EVERSALS
/ X $6 -
--
RE t •L l
14 SEWAGE EJECTOR 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 X $6 -
R.P.B.P.D.FOR:VATS,TANKS,BOILERS
17 SPRINKLER SYSTEM X $25 -
18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL X • $6
• HOLDING TANK
19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 -
20 MISC.PLUMBING FIXTURE X $6 -
SUBTOTAL: 67.
HOD OF PAYMENT
',N.' t. PLUS PROCESSING FEE: $35.00
,SH _ 0 CHECK 0 an= 0
' • ' i TOTAL PERMIT FEE DUE: [..// d e,
E: EXPIRES: � D
KCARD NUMBER: P
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HOMED SIGNATURE: 4 e 47 4
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