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2003, 11-12 Permit App: BLD-03-03052 Plumbing Reversal, Fixtures
( art cuj� 11707 East Sprague Avenue,Suite 106 509-688-0036 Phone 1J . iie Spokane Valley,WA 99206 509-688-0037-Fax lley Plumbing Permit Application PROJECT / PERMIT ADDRESS: / /y /V `S /�c, 7L USE: OWNER: 56:24?.._//--...__)�n� PHONE(Daytime Contact): MAILING ADDRESS: , ,S 7fizol (street) (city/state) - (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: o I s 4 , PV-PHONE II: C�I atr' -'G / 77497 5 ,' L/— .570 S' /9E/Y- � S/r�4-c iv tc': C9-/'e_c✓l9/Q-C_`c- S 'ie.04- /' (street) ✓ (city/state) (LIP) ' 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 SOFTENERX $6 - _ 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL X $6 - 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 - _.... 12 FFOUNTAINS,DRINKING-DRINKING- - _. _.. -_ _ X _ $6 - 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING REVERSALS X $6 - REVERSAL / 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 R.P.B.P.D.FOR:VATS,TANKS,BOILERS X - 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 - ETHOD OF PAYMENT SUBTOTAL: l 0 e a • •'ftt,5lr� PLUS PROCESSING FEE: $35.00 CASH 0 CHECK ❑ an= ,❑ - TOTAL PERMIT FEE DUE: 6 06 ,TE: EXPIRES: NKCARD NUMBER THORIZED SIGNATURE: