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2003, 05-08 Permit: BD-03-119 Plumbing Reversal
IETHOD OP ] CASH ATE Sfin ..�`Ualley Plumbing Permit Application 11707 East Spra e Avenue, Suite 106 509-688-0036 - Phone Spokane Valle} WA 99206 509-688-0037 - Fax €Do3—(i9 PROJECT ADDRESS: 71/ley E 421-" 4-,/L PERMC USE: DETAILS OWNER G�At0 R Ye-cce.1 PHONE (Daytime Contact): 9a7 t960 MAILING ADDRESS: 11 7i9' C 9 '-9oJlaanse O,t> Qga/v (street) TOILETS WATER CLOSET, BIDETS (dty/state) (ZIP) CONTRACTOR: _ - 2 LICENSE A: MAILING ADDRESS: PHONE It: TUBS X $6 (street) .. (city/state) (ZIP) PLUMBING PD(TURE$ NKCARD NUMBER: JTHORIZED SIGNATURE: DESCRIPTION DETAILS t OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET, BIDETS X _ - 2 URINALS X• 3 TUBS X $6 4 SHOWERS (PER TRAP) BATH, STALL, ONSITE BUILT X $$ - 5 SINKS LAVS/BASINS, BAR FLOOR KITCHEN, LAUNDRY, VIILrTY, JANITOR PHOTO; X- RAY, FOOD, PREP/CULINARY/MEAT X $6 - 6 DISHWASHER - X $6 - J CLOTHES WASHER X - 8 GARBAGE DISPOSAL X 16 - 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 E6 - 12 FOUNTAINS, DRINKING X $6 - 13 WATER PIPING/DRAIN-1N WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR REVERSALS X a— $6 - 14 SEWAGE fiJECTDR GRINDER SUMP PUMP X - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER HOSE BB, STEAMER, ?ROOFER CARBONATOR, SWAMP COOLER X $6 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER CHECK VALVE, AND R.P.B.P.D. FOR; VATS, TANKS, BOILERS X - 17 SPRINKLER SYSTEM X $25 - 15 INTERCEPTORS GREASE TRAP SAND TRAP, CHEMICAL HOLDING TANK X $� 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 - 20 MISC. PLUMBING FIaTITRE X Sfi - PAYMENT VISA CHECK El 0 mute. T�S.r,.aGz� SUBTOTAL: (9-1-• PLUS PROCESSING FEE: $35.08 TOTAL PERMIT FEE DUE: % /�n NKCARD NUMBER: JTHORIZED SIGNATURE: U/1dP�/'G foonno�" t (UmiJ/?S' 9 few fd S 2--6 3 Zel // S --Y- 3 i✓/