Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
2003, 11-17 Permit App: BLD-03-03091 Plumbing Reversal
►Sart<xj�� rrr,, 11707 East Sprague Avenue, Suite 106 509-688-0036 Phone polLane Spokane Valley,WA 99206509-688-0037-Fax 4,0000Malley Plumbing Permit Application PROJECT PERMIT • ADDRESS: 6-7,4 Gl USE: OWNER: LtiM 12-x- PHONE(Daytime Contact): MAILING ADDRESS: / I / / ` / 2./2 (street) (city/stat-/, / A' (ZIP) CONTRACTOR: , i 1 r LICENSE#: /4 MAILING ADDRESS: PHONE#: • 1)zr h 1 iLi ,21 '51G‘,/ ht-f' 4- ,4 cszi2- (street) (city/state) (LII') - 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 - RP.B.P.D.FOR:VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: iTHOD OF PAYMENT NNW • • ga5t PLUS PROCESSING FEE $35.00 CASH ❑ CHECK ❑ NM= .0 _ -::.L'-._ - TOTAL PERMIT FEE DUE: TE: EXPIRES: VKCARD NUMBER: THORIZED SIGNATURE:.