2001, 07-27 Permit App: 01006217 Plumbing ReversalPLUMBING PERMIT APPLICATION
PROJECT ( _quo /
ADDRESS: (i pa E l 1 �` , q {pyo to
PERMIT
I
USE: 1 j.KIN �( in -R� C ��?'S
OWNER:I
kva,. a � ,QS
PHONE (Daytime Contact):
9 -- 5 -`Eat Z
MAILING A ESS:
(Street) (City/State) (Zip)
CONTRACTOR:
LICENSE:
MAILING ADDRESS:
PHONE:
(Street) (City/State) (Zip)
PLUMBING FIXTURES
DESCRIPTION
DETAIL
# OF
UNITS
MULTI-
Pay
COST/
UNIT
EQUALS
AMOUNT
B02
TOILETS
WATER CLOSETS, BIDETS
x
$6
—
B03
URINALS
x
$6
—
B04
TUBS
-
x
$6
—
B05
SHOWERS (per trap)
BATH, STALL, ON-SITE BUILD
x
$6
—
B06
SINKS
LAVS/BASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD
(PREP/CULINARY/MEAT
x
86
—
B07
DISHWASHER
-
x
86
—
B08
CLOTHES WASHER
-
x
$6
—
B09
GARBAGE DISPOSAL/GRINDER
-
x
86
—
B10
WATER SOFTENER
-
x
86
—
B11
ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank see
mechanical)
x
86
—
B12
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
x
86
—
B13
ROOF DRAINS/OVERFLOW DRAINS
(ea.)
-
x
86
—
B14
FOUNTAINS, DRINKING
-
x
86
—
B15
WATER PIPING/DRAIN-IN WASTE-
VENT/PLUMBING REVERSALS
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
i
x
86
-
`-� 1��,
B16
SEWAGE EJECTORS
GRINDER, SUMP PUMP
x
$6
—
B17
WATER USING DEVICES
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLERS
x
86
—
B18
CROSS CONNECTION DEVICES
VACUUM BREAKER, CHECK
VALVE, AND R.P.B.P.D. FOR :
VATS, SUMPS, TANKS, BOILERS, &
SPRINKLER SYSTEMS
86
—
B19
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
x
86
—
B20
MEDICAL GAS (per outlet/bottle station)
NITROUS, OXYGEN
x
$6
—
B21
MISCELLANEOUS FIXTURES
$6
—
METHOD
OF PAYMENT
SUBTOTAL
/ V_
PLUS PROCESSING FEE
$ 25.00
RAF;
■ CASH • CHECK • MN= ■
■
WITH PAYMENT
CARD
DATE:
BANKCARD
ATITT-T
FAXED PERMITS WILL ONLY BE ACCEPTED
OF A MAJOR CREDIT
EXPIRES:
TOTAL PERMIT FEE DUE
W
MINIMUM PERMIT FEE IS $35.00
PLEASE MAKE CHECKS PAYABLE TO
SPOKANE COUNTY PERMIT CENTER
NUMBER:
112T7Fll STC,NATTTRR•
Spokane County Division of Building & Code Enforcement
1026 West Broadway Avenue * Spokane, WA 99260-0050
Telephone No. (509) 477-3675 * Fax No. 477-7198 * TDD No. (509) 477-7133