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2005, 03-24 Permit App: 05000902 Plumbing ReversalOwner: _ Mailing Address: Contractor: Mailing Address: PLUMBING PERMIT APPLICATION Phone: (509)688-0036; FAX: (509) 688-0037 For Inspections, Call (609) 688-0054 C's - �?c Community Development Department Building Division 11707 E. Sprague Avenue, Suite 106 Spokane Valley, WA 99206 Permit Use: Phone �(Daytime Contact): �A'Fl-M� _ (4%4 - City V State Zq License #: Phone #: -33--S2 ?_( Z BANKCARD AUTHORIZED SIGNATURE: DESCRIPTION OF WORK #0F NITS X .COST- TOTAL AMOUNT 1 TOILETS WATER CLOSET, BIDETS X f600. - 2 URINALS - % $6.00 - 3 TUBS 154 X $600 - 4 SHOWERS PER TRAP BATH STALL ONSITE BUILT X $6.00 5 SINKS -AVS/BASINS, BAR. FLOOR, KITCHEN, LAUNDRY, UTILITY. JANITOR, PHOTO, X-RAYr FOOD..PREPICULINARY MEAT % $6.00 = 6 DISHWASHER X $6.00 - 7 CL07HESWASHER X $6.00 - 6 GARBAGE DISPOSAL % $500 - 9 WATER SOFTENER X $600 - 10 ELECTRIC HOTWATER TANK NOTE' IF GAS, SEE MECHANICAL X $600 - 11 FLOOR DRAMS AREA, CASE. COIL. TRENCH CONDENSATE X $6.00 - 12 ROOF DRAINSIOVERFLOW DRAINS - % $600 - 13 FOUNTAINS, DRINKING X $600 - 14 WATER PIPINGIORAIN-IN WASTE, VENT PLUMBING REVERSAL NSTALIATION, ALTERATION, REPAIR .REVERSALS X $600 - / 15 SEWAGE EJECTOR GRINDER SUMP PUMP X $600 - 15 WATER USING DEVICE ICE ANIOR COFFEE MAKER, HOSE BIB, STEAMER PROOFER, CARBONATOR SWAMP COOLER X $600 = 17 CROSS CONNECTION DEVICE VACUUM BREAKER C HECK VALVE, AND RP.SP.O. FOR: VATS, TANKS. BOILERS X $600 - 16 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $600 - 19 MEDICAL GAS rowel NITROUS, OXYGEN X 20 MISCELLANEOUS PLUMBING FUTURE - XIiii 1 PRIVATE SEWAGE DISPOSALSYS XNDUSTRIALWASTE 22 INTERCEPTOR % METHOD OF PAYMENT: SUBTOTAL ❑ CASH ❑ CHECKPROCESSING FEE ❑ VISA ❑ MASTERCARD - DATE. EXPIRES TOTAL PERMIT FEE DUE: _ S35.00 BANKCARD AUTHORIZED SIGNATURE: