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2004, 03-25 Permit App: BLD-04-03904 Plumbing ReversalSm'�°`kan e`°' . Ua11ey Project Address: N . 1 ci'i WDOG{ r J� Owner: —To me -5 C% r I Mailing Address: N - 17 y k)ocd rru FC Contractor: GO6fr 50-,1 4 Sol /O' License #. Phone #: )11 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 Permit Use: Phone (Daytime Contact): VI- n-92 0bL_ 14 chat* /1,4,e i-gilceite.=city State Zip Code Mailing Address: City State BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code DESCRIPTION OF WORK # OF UNITS X COST - TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X 56.00 = 2 URINALS X 56.00 = 3 TUBS X 56.00 = 4 SHOWERS (PER TRAP) BATH, STALL, ONSITE BUILT X 56.00 = 5 SINKS LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO. X-RAY, FOOD, PREP/CULINARY/MEAT X $6.00 = 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X 56.00 = 9 WATER SOFTENER X 56.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS, SEE MECHANICAL X 56.00 = 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6.00 = 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING, REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS X $6.00 = 15 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X 56.00 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR VATS, TANKS, BOILERS X 56.00 = 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS (per outlet) NITROUS, OXYGEN X $6.00 = 20 MISCELLANEOUS PLUMBING FIXTURE X 56.00 = METHOD OF PAYMENTT�::!!!! ❑ CASH 00 CHECK ❑ VISA 0 MASTERCARD DATE: EXPIRES: SUBTOTAL PROCESSING FEE 535.00 TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: Zip Code