HomeMy WebLinkAbout2004, 06-30 Permit App: BLD-04-04814 Plumbing ReversalQ1Y
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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: /7,111 ' A i lc-.uu Permit Use:
Owner. Phone (Daytime Contact): 9 l star
Mailing Address: P S ?cc& e 5po k4Nz_ ( lAJA.
City State Zip Code
License #: Phone #: 2_11r /fO yc%
Contractor. Co vv--e-V\Gk i �e
Mailing Address: 19'31g c. S0✓'&9 vc
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City
State
996x,
Zip Code
BANKCARD NUMBER:
AUTHORIZED SIGNATURE:
DESCRIPTION OF WORK
1F OF
UNITS
X
COST
-
TOTAL
AMOUNT
1
TOILETS
WATER CLOSET, BIDETS
X
56.00
=
2
URINALS
X
46.00
=
9
TUBS
X
$6.00
=
4
SHOWERS (PER TRAP)
BATH, STALL, ON-SITE BUILT
X
58.00
=
5
SINKS
LAVSIBASINS, BAR, FLOOR,
KITCHEN, LAUNDRY, UTILITY,
JANITOR, PHOTO, X-RAY, FOOD,
PREP/CULINARY/MEAT
X
16.00
=
6
DISHWASHER
X
56.00
=
7
CLOTHES WASHER
X
56.00
=
8
GARBAGE DISPOSAL
X
18.00
=
9
WATER SOFTENER
X
58.00
=
10
ELECTRIC HOT WATER TANK
NOTE IF GAS, SEE MECHANICAL
X
$8.00
=
11
FLOOR DRAINS
AREA, CASE, COIL, TRENCH,
CONDENSATE
X
16.00
=
12
ROOF DRAINS/OVERFLOW DRAINS
X
56.00
=
13
FOUNTAINS, DRINKING
X
56.00
=
14
WATER PIPING/DRAIN-IN WASTE,
VENT, PLUMBING, REVERSAL
INSTALLATION, ALTERATION,
REPAIR, REVERSALS
X
56.00
=
15
SEWAGE EJECTOR
GRINDER, SUMP PUMP
X
58.00
=
16
WATER USING DEVICE
ICE AMOR COFFEE MAKER,
HOSE BIB, STEAMER PROOFER,
CARBONATOR, SWAMP COOLER
X
56.00
=
17
CROSS CONNECTION DEVICE
VACUUM BREAKER CHECK
VALVE, AND RP.B.P.D. FOR
VATS, TANKS, BOILERS
X
58.00
=
18
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
X
56.00
=
19
MEDICAL GAS (per outlet)
NITROUS, OXYGEN
X
56.00
=
20
MISCELLANEOUS PLUMBING FIXTURE
X
58.00
=
MEE3IGD OF PAYMENT:
®CASH ❑ CHECK ❑ VISA 0 MASTERCARD
DATE _ EXPIRES:
SUBTOTAL
PROCESSING FEE
$35.00
TOTAL PERMIT FEE DUE:
BANKCARD NUMBER:
AUTHORIZED SIGNATURE: