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2003, 11-20 Permit App: BLD-03-03111 Plumbing FixturesHOD OF 5SH I Smrn77���� �0 11707 East Sprague Avenue, Suite 106 509-688-0036'- Phone C(Pe Spokane Valley, WA 99206 509 -688 -0037 -Fax ..jvauey Plumbing Permit Application PROJECT DESCRIPTION PERMTT ADDRESS �E-�QZ X USE: EQUALS C- OWNER,y. PHONE (Dayfime Contact): MAILINGADDRFSS: §6 (street) (dty/state) (ZIP) CONTRACTOR: J AIIGAD3 PHONE#: 56 2MN r w OWERS (PER TRgP) BATH, STALL, ON-SITE BUILT (street) (dty/state) (ZIP) PLUMBING FIXTURES mr!RE:: :GRD NUMBER [ORIZED SIGNATURE: DESCRIPTION I DL1,US #OF=Sl X I COST EQUALS AMOUNT ILETS WATER CLOSET, BIDETS X §6 RINALS X UBS X 56 OWERS (PER TRgP) BATH, STALL, ON-SITE BUILT X §6 NKS LAVS/BASMS, BAR FLOOR, KTPCHEN, LAUNDRY, UTILRY, JANITOR PHOTO, x- RAY,FOOD,PREP�CULINARY/MEAT X S6 - SHWASHER X 56 OTHEB WASHER X RBAGE DISPOSAL - X _ VNDR ATER SOFTENER X $6 ECTHOPWATERTANK NOTE. IF GAS, SEE MECHAMCAL X 56 OOR DRAMS AREA, CASE, CO14 TRENCHCONDENSX UNTAINS, DRINKING X BE ATERPIPINGJNR dN-IN VENT, PLUMBING INSTALLATION, ALTERATION, REPAIRgSTE, REVERSALS X E6VERSALWAGE EJECTOR GRINDER, SUMP PUMX ATER USING DEVICE ICE AND/OR COFFEE MAKER HOSE BIB, STEAMER PROOFER CARBONATOR, SWAMPCOOLER X 56 - 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.I P.D. FOR: VATS, TANKS, BOILERS X 55 I7 SPRINKLER SYSTEM X 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMIUL HOLDINGTANK 'X S5 - - 19 MEDIGALGASE-outlet NITROUS, OXYGEN X $6 2➢ hINaC. PLIIMBMGFIXTVRE x PAYMENT r '-YISi' D CHECK ❑ ❑ _-..--_.. SUBTOTAL: PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: mr!RE:: :GRD NUMBER [ORIZED SIGNATURE: