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2003, 09-02 Permit App: BLD-03-02362 Plumbing Reversal, Fixtures Saro cx +/ rk 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone Oo nC Spokane Valley,WA 99206 509-688-0037-Fax Walley For Inspections, call 509-688-0054 Plumbing Permit Application £2 ?Y 231,-).. PROJECT PERMIT ADDRESS: t7.2..---z. , S•.„-i.(en lA,,j USE: OWNER: , PHONE(Daytime Contact): MAILING ADDRESS: 3 02 i /, 1, �� s,,, ,kyr r:',A "N 2/2- (street) (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: -1 /F� 2_c_40/*/-1.2-2 C' �kz 4iz.�t-�-r 1.-, 4/L MAILING ADDRESS: PHONE#: Sze--c26 / / I , , e , (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 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 X $6 - RP.B.P.D.FOR:VATS,TANKS,BOILERS 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 - SUBTOTAL: 4ETHOD OF PAYMENT • VIS •�Pfast ; PLUS PROCESSING FEE: $35.00 ] CASH 0 CHECK 0L 0 L...._.. ...4'...'i . TOTAL PERMIT FEE DUE: ,( >ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: