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2004, 09-29 Permit App: BLD-04-07804 Plumbing Reversal • PLUMBING PERMIT APPLICATION e City of Spokane Valley Community Development Department BuildingDivision ,R lei 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 do, Phone: (509)688-0036;Fax: (509)688-0037 /1102 / FOR INSPECTIONS, CALL(509)688-0054 / Project Address: L/�6/ �• 3( / f/ Permit Use: . Owner: A / eA Hoi R, hoi to C / Phone (Daytime Contact): Mailing Address: PI) c/ . 5/.rmd 4Ac/G / ' City State Zip Code Contractor. 6'P L �a �(��( h. i License#: An il-P_ Phone#: 9D-/- 7 Mailing Address: 3 I of „5". afiiii o H1 in0t)/9- 941(7.:3 - L City lit Zip Code #OF TOTAL DESCRIPTION OF WORK UNITS X COST - 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,ONSITE BUILT X $6.00 = 5 SINKS LAVS/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD. PREP/CULINARY/MEAT 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = e GARBAGE DISPOSAL X $6.00 1 . 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, X $6.00 CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS,DRINKING X $6.00 • 14 WATER PIPING/D ASTE, INSTALLATION,ALTERATION, X $6.00 VENT, PLUMBI�E�E� REPAIR,REVERSALS / 4 --L '6-1 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X $6.00 CARBONATOR,SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK . VALVE,AND R.P.BP.D.FOR: X $6.00 VATS,TANKS,BOILERS 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = • METHOD OF PAYMENT: SUBTOTAL 0 CASH 0 CHECK 0 VISA 0 MASTERCARD PROCESSING FEE J/$35.00 �7 DATE: EXPIRES: TOTAL PERMIT FEE DUE: L!(/ BANKCARD NUMBER: AUTHORIZED SIGNATURE: