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2004, 10-18 Permit App: BLD-04-07947 Plumbing ReversalPLUMBING PERMIT APPLICATION City of Spokane Valley Community Development Department BuildingDivision 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Phone: (509) 688-0036; Fax: (509) 688-0037 FOR INSPECTIONS, CALL (509) 688-0054 Permit Use: , Phone (Daytime Contact): C/ c / 6c3 Project Add ss: Owners _, Mailing Address: ,oq .--a // i�,5 us tate Contractor. 6,P I_ f nil 19 ritt /-4104iYA License #: n ,..-/-/-P__ Mailing Address: 0 )a .S• dc/a nhf14 b/) 996,3 St 7 a e City Zip Code Phone #: 9'�/- / 3 BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK *OF UNITS - X COST TOTAL AMOUNT 1 TOILETS ' WATER CLOSET, BIDETS X $6.00 = 2 URINALS X $6-00 = 3 TUBS X $6.00 4 SHOWERS (PER TRAP) BATH, STALL, ON-SITE BUILT X $6.00 '- 5 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT X 56.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X $6.00 = - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS,. DRINKING X $6.00• = 14 WATER PIPING/ORA! - TE, VENT, PLUMB! , R ERSAL) INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6.00 =/ = = /_P - C/ l/ — 15 GRINDER, SUMP PUMP ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X X $6.00 $6.00 SEWAGE EJECTOR 16 WATER USING DEVICE 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND RP.B.P.D. FOR VATS, TANKS, BOILERS X 56.00 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: 0 CASH 0 CHECK DATE 0 VISA 0 MASTERCARD EXPIRES: -- SUBTOTAL PROCESSING FEE $35.00/ TOTAL PERMIT FEE DUE: 0 ) % /. �/ Z) BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code