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2004, 02-17 Permit App: BLD-04-03557 Plumbing Reversal
Sar� <rU rrrr,. p11i ..rte Valle Plumbing Permit Application 11707 East Sprague Avenue, Site 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call' 509-688-0054 PROJECT %, ADDRESS: - / // ;� /? PERMIT USE: OWNER:"1 PHONE (Daytime Contact .7:-/ _ MAILING ADDRESS: �- (street) (city/state) (ZIP) CO Ai , IR:, , AO'� Ai,_ LICENSE #: MAILING ADDRESS: 3 C/ /D s- .() a 5 13 OL PHONE #: qcD, 1— 59/ 3 q967____. (street) (city/state) (ZIP) PLUMBING FIXTURES DESCRIPTION 1 TOILETS 2 URINALS 3 TUBS DETAILS WATER CLOSET, BIDETS 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT 5 SINKS 6 DISHWASHER 7 CLOTHES WASHER 8 GARBAGE DISPOSAL 9 WATER SOFTENER LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- X $6 RAY, FOOD, PREP/CULINARY/MEAT # OF IINTTS X COST EQUALS AMOUNT X $6 X $6 - X $6 X $6 10 ELECT. HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE 12 FOUNTAINS, DRINKING 13 WATER PIPING/DRAIN-IN INSTALLATION, ALTERATION, REPAIR, WASTE, VENT, PLUMBING . REVERSALS REVERSAL 14 SEWAGE EJECTOR GRINDER, SUMP PUMP 15 WATER USING DEVICE 16 CROSS CONNECTION DEVICE 17 SPRINKLER SYSTEM ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR VATS, TANKS, BOILERS X $6 X $6 X $6 - X $6 - X $6 X $6 X $6 X $6 - X $6 X $6 X $6 - GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK NITROUS, OXYGEN $25 OD OF PAYMENT ❑ CHECK 0 X. ❑ ARD NUMBER: EXPIRES: FUZED SIGNATURE: $6 SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: