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2003, 06-05 Permit App: BD03-589 Plumbing Fixtures
So7Y +/"� 11707 East Sprague Avenue,Suite 106 509-688-0036 -Phone ( e Spokane Valley,WA 99206 509-688-0037-Fax .....*Valley Plumbing Permit Application 's (,.,-.5 PROJECT PERMIT ADDRESS: 67e , �I // , USE:i OWNER: n %1hi../ PHONE(DaymeContact): Ge! /1 r S 04 ' ti ,.. ---3,,......,???_5----- MAILING ADDRESS: (street) (city/state) (ZIP) CONTRACTOR: / --mac:, � — LICENSE#: , 9csRc6r4fr.v�' Cvr�S<��c°fiiLI"CC * /7/ ,e7 MAILING ADDRESS: "ge J z- 6.4.-) ' 19 '!1 .510.e",, u e- (i_'") . 0/.6 (street) (city/state) 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 LAVS/BASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILI'T'Y,JANITOR,PHOTO;X- X $6 - 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 ..._� ________._. 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 - ['HOD OF PAYMENT SUBTOTAL: i^ r f: PLUS PROCESSING FEE: $35.00 .ASH ❑ CHECK ❑ ❑ i ' TOTAL PERMIT FEE DUE: y/; H: EXPIRES: KCARD NUMBER �.t Cl/i sk i /, Lye'? / /1 ‘ _43 -03 FIORIZED SIGNATURE_: 77\ t/ 1�116- 6 G/>1 G• / � /3 —e