Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2005, 11-21 Permit App: 05004426 Sewer Reversal
Spokane Valley Community Development Plumbing Permit Permit Center 11707 E Sprague Ave, Suite 106 Spokane Valley, WA 99206 (509)688-0036 FAX: (509)688-0037 www.spokanevalley.oru.com Application PERMIT NUMBER: T2- PERMIT FEE: ❑ Commercial ❑ Residential SITE ADDRESS_ Buildingownr DESCRIPTION OF WORK Name: ,d!/7 �j9/j,j Phone:// 5 9 JJ -/2 96 Fax: Address: //6- 21 e A //', £ t ' i/ City: ,S /A,..vK State: e-CCOXip: 99 2�J,,C Contractor 1 TOILETS Name: Phone: Fax: Address: City : State: Zip: License No: City Business License No: Contact X $6.00 Name: Phone: 3 AUTHORIZED SIGNATURE: REVISED 8/26/05 DESCRIPTION OF WORK # OF UNITS X COST = TOTAL 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, ON-SITE BUILT X $6.00 = 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY MEAT X $6.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 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, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 13 FOUNTAINS, DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL NSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6.00 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR, SWAMP COOLER X $6.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X $6.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = 22 INDUSTRIAL WASTE INTERCEPTOR X_ $15.00 = METHOD OF PAYMENT: ❑ CASH ❑ CHECK Card# SUBTOTAL 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 EXPIRES: TOTAL PERMIT FEE DUE: AUTHORIZED SIGNATURE: REVISED 8/26/05