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2003, 12-19 Permit App: BLD-03-03318 Plumbing Reversal
X174 tM; /° 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone Spokar]e Spokane Valley,WA 99206 509-688-0037-Fax 40,ValleY For Inspections, call 509-688-0054 Plumbing Permit Application PROJECT PERMIT ADDRESS: /30 9' At (A/> 4/./r- USE: OWNER: V _e r_ i - e A,' h Q i d e PHONE(Daytime Contact): MAILING ADDRESS: !30 y At tjJ16,Er- 3AB LJA 9q Zd (street) (a /state) (ZIP) CONTRACTOR: i3e/ /��p LICENSE#: MAILING ADDRESS: �l PHONE#: (street) (city/state) (ZIP) ' 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 INSTALLATION,ALTERATION,REPAIR, WASTE,VENT,PLUMBING REVERSALS / 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 X $6 - R.P.B.P.D.FOR:VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL _ HOLDING TANK X 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 = SUBTOTAL: METHOD OF PAYMENT MOM ,Fk"as • PLUS PROCESSING FEE: $35.00 ❑ CASH 0 CHECK 0 MAW 0 L_.-.-~="`-. . TOTAL PERMIT FEE DUE: ( •J 00DATE: EXPIRES: ` BANKCARD NUMBER: AUTHORIZED SIGNATURE: