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2003, 06-05 Permit App: BD03-274 Plumbing Fixtures 400",140. ' o!k<' rrk„ 11707 East Sprague Avenue,Suite 106 509-688-0.036 - Phone Spokane Valley,WA 99206 509-688-0037-Fax ......0Vatiey Plumbing Permit Application I.1) 0 3_ €.27,/ c'-'S PROJECT PERMIT ADDRESS: 6 D "17 r� �� USE: • OWNER: i 4,,,,, „,, ..e"1/4.).5,0 ra.../ PHONE(Daytime Contact): MAILING ADDRESS: ��iz �Jg� (street) (city/state) (ZIP) CONTRACTOR: 0,ec / ows ,,� LICENSE#: MAILING ADDRESS: R 19S'/1 E S r.9- u P 11_9A (street) (city/state) (Gll') PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMO RsIT 1 TOILETS WATER CLOSET,BIDETS 2 URINALS / X $6 _ 3 TUBS X $6 - 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT / X $6 X _ 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, $6 LAUNDRY,UTILITY,JANITOR,PHOTO;X- X $6 RAY,FOOD,PREP/CULINARY/MEAT / /� 6 DISHWASHER l0 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 _ X $6 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 12 FOUNTAINS,DRINKING 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION,REPAIR, X $6 .. - -1tASTE,VENT'PLUMBING REVERSALS - REVERSAL / - 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X C/a' 15 WATER USING DEVICE $6 ICE AND/OR COFFEE MAKER,HOSE BIB, STEAMER,PROOFER,CARBONATOR, X $6 SWAMP COOLER 16 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND • R.P.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 20 MISC.PLUMBING FIXTURE $6 X $6 ['HOD OF PAYMENT SUBTOTAL: .2.4/0 0 'tit ' : :ASH [] 0 t,_ PLUS PROCESSING FEE ❑ ter._ _ $35.00 • TOTAL PERMIT FEE DUE: g--"7.0 a E: EXPIRES: <CARD NUMBER: IORIZED SIGNATURE: