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2003, 11-05 Permit App: BLD-03-02982 Plumbing Reversal
Sc�r��x 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pokane Spokane Valley,WA 99206 509-688-0037-Fax _f Val11y For Inspections, call' 509-688-0054 Plumbing Permit Application 63_o a PROJECT PERMIT ADDRESS: /1p c9 � % p ]` USE: OWNER: J l;ni 06_4"w lO PHONE(Daytime Contact): (5.(3-2_6 /D 91 MAILING ADDkESS. //( ` 1 It -7 ILS C. `-11 6ICL. ,5 0 X12 (,aoL_ q?3,6 Ca (street) (city/state) (ZIP) COIy R,AA r )1 G„ ^6� �>/( k/3 )I �11 / LICENSE#: MAILING ADDRESS: 7 ( PHONE#: — 3 /AD s- &lS q s - 5-q/ 3 f 0 10 et___ X1963 '7 (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 9 WATER SOFTENER $6 - X $6 - 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL X II FLOOR DRAINS $6 - AREA,CASE,COIL,TRENCH,CONDENSATE X $6 12 FOUNTAINS,DRINKING - - 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, X $6 WASTE,VENT,PLUMBING. :EVE REVERSAL / X $6-- 14 6 -14 SEWAGE EJECTOR GRINDER,SUMP PUMP 15 WATER USING DEVICE X ICE AND/OR COFFEE MAKER,HOSE BIB, STEAMER,PROOFER,CARBONATOR, X $6 _ SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.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 20 MISC.PLUMBING FIXTURE X $6 - X $6 MOD OF PAYMENT SUBTOTAL: YISA" • •ins, - ' :ASH ❑ CHECK ❑ ' _�.'' PLUS PROCESSING FEE: ❑ $35.00 TOTAL PERMIT FEE DUE: (l`//}tel E. EXPIRES: (/V KCARD NUMBER: 3ORIZED SIGNATURE: