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2003, 04-09 Permit: BD03-063 Plumbing Reversal
Cit•�,�• 0144106, 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone Spol �ane Spokane Valley,WA 99206 509-688-0037-Fax _Valley Plumbing Permit Application BD 03 -O(9� PROJECT PERMIT ADDRESS: . /4„ fv, 5' ��i„iv fua USE: OWNER: v 1 12_-"i";17.7/,�.i' PHONE(Daytime Contact): 92€ _ g?$ I�7 MAILING ADDRESS: .?!4-M`P (street) (city/state) (ZIP) CONTRACTOR:-7-2_ � [ 7vny,5,/,��Z / yc�� LICENSE#: .,-.7.. /.mL. MAILING ADDRESS: PHONE#: e,84, s. y-(t-d ied, '75'4, . 36 yT (street) (city/state) (ZIP) 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,DRINKING X $6 - 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING REVERSALS / llf/X $6 - / f REVERSAL CO 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: METHOD OF PAYMENT `dQ Masa d' PLUS PROCESSING FEE: $35.00 0 CASH 0 CHECK 0 ins= 0 E_._.........-f- , TOTAL _`..-'- TOTAL PERMIT FEE DUE: L/l OO . c- 11 DATE: G[ ` -�`—� EXPIRES: BANKCARD NUMBER AUTHORIZED SIGNATURE: