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2003, 07-15 Permit App: BLD-03-02032 Plumbing Reversal
Sart cX 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone j3 ikane Spokane Valley,WA 99206 509-688-0037-Fax ,,jValley For Inspections, call' 509-688-0054 Plumbing Permit Application PROJECT . PERMIT ADDRESS' 1 L( f V ` '5 , .,C( / USE: OWNER: 4) 4 ( hi I i m ( PHONE(Daytime Contact): 9 �__.-? 6/s, MAILIN DDRESS: /S l 1 /LI 1 b Lil . c5C. 14(tel,te -(4,1 d ' 961)64 .(J)0- W6)6 (street) (city/state) (ZIP) CO�Ps LR:e 11 pI I L�� / i(V LICENSE#: MAILING ADDRESS: PHONE#: _ e.,...5- ,3 e/ /,D �- S ClH I 9l 40 0-kcicKs /JCL (19 63 a) (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 LAVS/BASINS,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 13 WATER PIPING/DRAIN-IN IN _ $6 ON,ALTERATION,REPAIR, j WASTE,VENT,PLUMBING. RE • A / 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 RP.B.P.D.FOR:VATS,TANKS,BOILERS X $6 - 17 SPRINKLER SYSTEM 18 INTERCEPTORS X $25 - GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 - 19 MEDICAL GAS per outlet NITROUS,OXYGEN 20 MISC.PLUMBING FIXTURE X $6 - X $6 THOD OF PAYMENT SUBTOTAL: YISA" • fifes ,' :ASH 0 CHECK 0 0 ;__ _w. PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: E: EXPIRES: KCARD NUMBER: 3ORIZED SIGNATURE: