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2003, 10-27 Permit App: BLD-03-02912 Plumbing Fixtures
Sm4 cx /Ore'' , 11707 East Sprague Avenue,Suite 106 509-688-0036 Phone pOkane Spokane Valley,WA 99206 509-688-0037-Fax .000Vt11ey Plumbing Permit Application PROJECT x0�i 74-4 , • PERMIT ADDRESS: �J 7 J' 9� USE: OWNER: .,,cros a/ 6-- ri,_il G PHONE(Daytime Contact): ,2..6 _15,7,7 MAILING ADDRESS: 44 'co f/0 t— 7 :/Plc 14- e/ 9nz (street) (ciy/state) (GU') �t CONTRACTOR: /..477/5 / PHONE#: LICENSE : /I//yp 97//33 MAILING ADDRESS: (street) (city/state) (ZIP) • PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS / X $6 - 4- 2 URINALS X $6 - 3 TUBS X $6 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6 = 65 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 - �� RAY,FOOD;PREP/CULINARY/MEAT / C✓ 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 $6 _ HOLDING TANK X 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: QCdy ETHOD OF PAYMENT "vim • • 4-fasCr PLUS PROCESSING FEE: $35.00 I CASH 0 CHECK ❑ iiiintin 0 —._ ..:.:1-2-. TOTAL PERMIT FEE DUE: ATE: EXPIRES: NNKCARD NUMBER JTHORIZED SIGNATURE: