Loading...
2003, 05-30 Permit: BD03-542 Plumbing Reversal cert c /� 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pokane Spokane Valley,WA 99206 509-688-0037-Fax 1/alley For Inpections, call 509-688-0054 Plumbing Permit Application ho 03-5 4� PROJECT PERMIT ADDRESS: b 7/q 12f4. USE: OWNER: PHONE(Daytime Contact): yc2oa —`/ref MAILING,� ADDRESS: ( �y �1 ,,// A G. 7 l / "` 4 6 ta.-.C f eft- I le:71/c9- (street) (city/state) (ZIP) CONTRACTOR 4 e i� C/4 r.,,z,..6 LICENSES: 24,6-�.a it, rio D/..2.LQ MAILING ADDRESS: Q✓) PHONE#: golf--- d-¢ 7q 4",, ‘7 14 Jo A �r 0.4-,aJ A4 9 qa2/..)._ (street) (city/state) (LIP) • 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 LAVSBASINS,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 - 7 Dg 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 RP.B.P.D.FOR:VATS,TANKS,BOILERS X 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL X HOLDING TANK - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: .. ETHOD OF PAYMENT I�k"MsI� PLUS PROCESSING FEE: $35.00 CASH 0 CHECK ❑ o _ . • TOTAL PERMIT FEE DUE: 79g-- STE: EXPIRES: LNKCARD NUMBER JTHORIZED SIGNATURE: