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2004, 03-30 Permit App: BLD-04-03938 Plumbing Reversal
METHOD 0 0 CASH DATE: crrt <x Spokane ,,,000Valley 11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone Spokane Valley, WA 99206 509-688-0037 - Fax For Inspections, call 509-688-0054 PP Plumbing Permit Application PROJECT ADDRESS: 1 -NI ( 5; 440 PERMIT USE: J y@jW tLJ -_ r PHONE (Daytime Contact): 9 e 6/Of 6OWNER: ilek-bit / Wiii- i9,0 MAILING ADDRESS: EQUALS (street)� (city/state) (ZIP) COMM t)RESS:r,� a 0 / t o . tic LICENSE #: $6 MAILING 3L//, S.dcio C PHONE #:^ [� 0 /• _ S_ 7 / 3 (street) (city/state) (ZIP) PLUMBING FIXTURES BANKCARD NUMBER: AUTHORIZED SIGNATURE: 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- RAY, FOOD, PREP/CULINARY/MEAT X $6 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 WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS ( X $6 - 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6 - 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X - 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIXTURE X $6 - PAYMENT CHECK • • • !g7.5 —_="`• • SUBTOTAL: PLUS PROCESSING FEE: $35.00 • ■ TOTAL PERMIT FEE DUE: (42 ,(;6 BANKCARD NUMBER: AUTHORIZED SIGNATURE: