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2003, 04-28 Permit App: BD03-185 Plumbing Fixtures
S£FH< 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pO"kane � Spokane Valley,WA 99206 509-688-0037-Fax .,,,OValley For Inspections, call 509-688-0054 Plumbing Permit Application g D O3- t -S' PROJECT PERMIT ADDRESS: sem, 5y //s/77, USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR /-' L-- ��'j yr ! e /,Ns, LICENSE#: �,m ur c c ' 72 if MAILING ADDRESS: /, � / PHONE#: 1. 9S+1 -�. 5-0 9 .gay- s- ?s / 2 8/F e s�✓",.-3� ei �.�v-� t.� , iICee 5 'c€- 9. F 5�0/A° (street) (city/state) (ZIP) ' PLUMBING FIXTURES DESCRIPTION DETAILS #OF UMTS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6 - (-Y 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6 - 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, 'C LAUNDRY,UTILITY,JANITOR,PHOTO,X- / X $6 - RAY,FOOD,PREP/CULINARY/MEAT Le 6 DISHWASHER X $6 - S 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 INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING REVERSALS` / X $6__ - REVERSAL Le 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 X $6 - RP.B.P.D.FOR:VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL $6 = HOLDING TANK X 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: METHOD OF PAYMENT .T4 AD UMW VISA Mast' PLUS PROCESSING FEE: $35.00 ❑ CASH ❑ CHECK ❑ iiiiffin ❑ ( ._._. ". �i TOTAL PERMIT FEE DUE: . --.9 DD DATE: V�O 4:::!..3 EXPIRES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: