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2003, Permit: BD03-440 Plumbing Fixtures SY c 11707 East Sprague Avenue,Suite 106 509-688-0036-Phone pakane Spokane Valley,WA 99206 509-688-0037-Fax .0,01/alley For Inspections, call 509-688-0054 Plumbing Permit Application g„0 O S--Licto PROJECT PERMIT ADDRESS: E 742_ /Q USE: OWNER: / PHONE(Daytime Contact): MAILING ADDRESS: (street) city/state) (ZIP) CONTRACTOR y// //a-.I f LICENSE#: MAILING ADDRESS: PHONE#: a.2/‘' _2.6 7/ %oma a ... s ��`- �19�0� (street) (city/state) (ZIP) 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 LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- / X $6 - ('�/- Q 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 .. " 0� 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 RP.B.P.D.FOR:VATS,TANKS,BOILERS X $6 - 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 - ETHOD OF PAYMENT SUBTOTAL: /`, -- CASH ❑ CHECK ❑ ❑ ! _ PLUS PROCESSING FEE: $35.00 TOTAL PERMIT FEE DUE: 4`, o iTE: EXPIRES: NKCARD NUMBER • THORIZED SIGNATURE: pwP/- rev'/ a 40/ fo✓Pa lc?`0 �� .