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2004, 05-25 Permit App: BLD-04-04444 Plumbing Reversal PLUMBING PERMIT APPLICATION SpCITY okane1\11.11,6City of Spokane Valley Community Development Department BuildingDivision Valley 11707 E. Sprague Avenue, Suite 106 4 0, Spokane Valley, WA 99206 Phone: (509) 688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address: )Vi!) E ry h, .- Permit Use: Owner: 'iii&—V l-ei5,.., Phone (Daytime Contact): Mailing Address: 69/e F 1. Wit' �yek, ,4. _ `�"`' City State Zip Code Contractor: ifr- c= }"«--*A:'t; License#: z 4-� Phone#: 2 c—/-R,)S`8 • Mailing Address: 3e)`27 `!/i// g<1 ��� '�-, ,i2e-7 City State Zip Code #OF TOTAL DESCRIPTION OF WORK UNITS X COST = AMOUNT 1 TOILETS WATER CLOSET,BIDETS X $6.00 = 2 URINALS X $6.00 ,_ 3 TUBSX $6.00 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT X $6.00 = 5 SINKS LAYS/BASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARY/MEAT 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER X $6.00 = 10 ELECTRIC HOT WATER TANK NOTE: IF GAS,SEE MECHANICAL X $6.00 = 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, X $6.00 = CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X $6.00 = 13 FOUNTAINS,DRINKING X $6.00 , = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, X $6.00 = VENT, PLUMBING,REVERSAL REPAIR,REVERSALS 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X $6.00 = CARBONATOR,SWAMP COOLER 17 CROSS CONNECTION DEVICE VACUUM BREAKER,CHECK VALVE,AND R.P.B.P.D.FOR: X $6.00 = VATS,TANKS,BOILERS , 18 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6.00 = CHEMICAL HOLDING TANK 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 .._ 20 MISCELLANEOUS PLUMBING FIXTURE X $6.00 = METHOD OF PAYMENT: SUBTOTAL ❑ CASH 0 CHECK 0 VISA 0 MASTERCARD PROCESSING FEE $35.00 DATE: EXPIRES: TOTAL PERMIT FEE DUE: BANKCARD NUMBER: AUTHORIZED SIGNATURE: