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2003, 11-13 Permit App: BLD-03-03055 Plumbing Reversal
iror • 11707 East SpragueAvertte,Suite 106 509-688-0036 Phone jrxj e � Spokane Valley,WA 99206 509-688-0037-Fax „ 000Va ley Plumbing Permit Application 0, ,._.,. , i0s.,_,K.,.... PROJECT / o"__ C 4 A 1,L PERMTT ADDRESS: ) (�I „, ; , USE: OWNER: PHONE(Daytime Contact r,- carp itL ius. c y ): MAILING ADDRESS: (0(I0c e as) Ave (street) (city/state) (LIP) CONTRACTOR: /, C M li Ek 0, LICENSE#: AL m e` *'-r 0 z I,D MAILING ADDRESS: PHONE#: 3 o6 V. L,u./ SFPkfi'ivt gl'zi� (street) (city/state) (LIP) - PLUMBING FIXTURES DESCRIPTION DETAILS #OF LIMITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6 - 2 URINALS X $6 - 3 TUBS X $6 r - 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 - 5 REVERSAL 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER,HOSE BIB, STEAMER,?ROOFER,CARBONATOR, X . $6 SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND $6 R.P.B.P.D.FOR:VATS,TANKS,BOILERS X 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL X $6 HOLDING TANK 19 MEDICAL,GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE j( $6 - SUBTOTAL: 2TFIOD OP PAYMENT ••_• • g` i PLUS PROCESSING FEE: $35.00 CASH 0 CHECK ❑ UMW a —. __`.'= . - TOTAL PERMIT FEE DUE: STE: EXPIRES: NKCARD NUMBER: THORIZED SIGNATURE:.