2004, 08-23 Permit App: BLD-04-07429 Plumbing Reversals
PLUMBING PERMIT APPLICATION
City of Spokane Valley Community Development Department
BuildingDivision
11707 E. Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Phone: (509) 688-0036; Fax: (509) 688-0037
FOR INSPECTIONS, CALL (509) 688-0054
Project Address: e3/ 3 f 1/4,1/GkuPermit Use:
Owner. /t3 /Eew,..l I Phone (Daytime Contact):
Mailing Address: 53 [3 3 5. r/a-✓/ �— 4-y �j�1cA>nr
city State Zip Code
Contractor. 14-1-3-1E EveAn41-4- License #: Phone #: Zs/ -9c'31
Zip Code
Ma'ling Address: 3 -tri tzL.
$»o A,F
State
BANKCARDNUMBER
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
MOF
UNITS
X
COST
•
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET BIDETS
X
$6.00
=
2
URINALS
X
56.00
=
3
TUBS
X
38.00
_
4
SHOWERS (PER TRAP)
BATH, STALL ONSITE BUILT
X
58.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARYIMEAT
X
$8.00
=
6
DISHWASHER
X
$6.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
36.00
=
9
WATER SOFTENER
X
$6.00
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$8.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
58.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
$6.00
=
13
FOUNTAINS, DRINKING
X
$6.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
\>
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
56.00
=
16
WATER USING DEVICE
ICEAN/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLER
X
58.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK
VALVE, AND RP.B.P.D. FOR
VATS, TANKS, BOILERS
X
56.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
$8.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
-
X
$6.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
58.00
=
METHOD OF PAYMENT:
Q CASH 0 CHECK 0 VISA 0 MASTERCARD
DATE EXPIRES
SUBTOTAL
PROCESSING FEE
535.00
TOTAL PERMIT FEE DUE:
BANKCARDNUMBER
AUTHORIZED SIGNATURE: