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2003, Permt App: BD03-312 Plumbing Reversal Scrrt c>t 1tt4r 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pokane Spokane Valley,WA 99206 509-688-0037-Fax Walley For Inspections, call 509-688-0054 Plumbing Permit Application o3- ) t PROJECT PERMIT ADDRESS: f I LiciLA ` 0 , + `"' _____ USE: OWNER: LL/ e PHONE(Daytime Contact): MAILING ADDRESS:� C �I �1����� r lCElLl 4 - Lal ,q)(5- J (OCL- 99 l �— (street)��DD (city/state) (ZIP) CO TER J� 11 y>/( I/JAZ 4, 7 1, LICENSE#: — MAILING ADDRESS:� /�j��Ty ..meq 3 PHONE#: �j � (ii(ems✓ "`S l 400-k3 ciL q96,� ') (street) (city/state) (7.IP) . PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6 _ 2 URINALS X $6 - 3 TUBS X $6 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6 5 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 = RAY,FOOD,PREP/CULINARY/MEAT 6 DISHWASHER X $6 7 CLOTHES WASHER X $6 = 8 GARBAGE DISPOSAL X $6 = 9 WATER SOFTENER X $6 - 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL X $6 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 - 12 FOUNTAINS,DRINKING X $6 13 WATER PIPING/DRAIN-IN I B-'k-1 TION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING. RE RS X $6 REVERSAL ( - 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB, - STEAMER,PROOFER,CARBONATOR, X $6 - SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND RP.B.P.D.FOR:VATS,TANKS,BOILERS X $6 = 17 SPRINKLER SYSTEM 18 INTERCEPTORS X $25 - GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X _ 20 MISC.PLUMBING FIXTURE $6 X $6 = THOD OF PAYMENT SUBTOTAL: r - ', ASH ❑ CHECK El ❑ ! _ __ PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: (f/r 6, E: EXPIRES: KCARD NUMBER: -IORIZED SIGNATURE: