2004, 05-11 Permit App: BLD-04-04326 Plumbing Reversalsgoka ce
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Plumbing Permit Application
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509-688-0037 - Fax
For Inspections, call 509-688-0054
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MAILING ADDRESS:
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MAILING ADDRESS:
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PLUMBING FIXTURES
DESCRIPTION
1
TOILETS
DETAILS
# OF UNITS
X
COST
WATER CLOSET, BIDETS
2
3
URINALS
TUBS
X
X
$6
$6
EQUALS
AMOUNT
4
5
6
7
8
SHOWERS (PER TRAP)
SINKS
X
$6
BATH, STALL, ON-SITE BUILT
X
$6
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CULINARY/MEAT
X
$6
DISHWASHER
CLOTHES WASHER
X
$6
GARBAGE DISPOSAL
X
$6
X
9
10
11
WATER SOFTENER
ELECT. HOT WATER TANK
FLOOR DRAINS
X
$6
$6
NOTE: IF GAS, SEE MECHANICAL
AREA, CASE, COIL, TRENCH, CONDENSATE
X
$6
X
$6
12
13
FOUNTAINS, DRINKING
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING
REVERSAL
X
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
$6
X
$6
14
15
16
17
18
SEWAGE EJECTOR
WATER USING DEVICE
GRINDER, SUMP PUMP
X
CROSS CONNECTION DEVICE
SPRINKLER SYSTEM
INTERCEPTORS
ICE AND/OR COFFEE MAKER, HOSE BIB,
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
$6
kD
VACUUM BREAKER, CHECK VALVE, AND
RP.B.P.D. FOR VATS, TANKS, BOILERS
X
$6
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$25
X
$6
19
20
MEDICAL GAS per outlet
MISC. PLUMBING FIXTURE
NITROUS, OXYGEN
X
$6
X
$6
TTHOD OF PAYMENT
CASH ❑ CHECK 0
TE:
EXPIRES:
NKCARD NUMBER
THORIZED SIGNATURE:
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
271/