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2005, 02-02 Permit App: 05000317 Plumbing Reversal
PLUMBING PERMIT APPLICATION Community Development Department Lyn olle\klik Building Division Phone: (509) 688-0036; FAX: (509) 688-0037 11707 E. Sprague Avenue, Suite 106 diValley For Inspections, Call (509) 658-0054 Spokane Valley, WA 99206 05._ -3 0 Project Address: , II_ — `t , Permit Use: Owner: /Oq . /r / Phoneh (Daytime Contact): 6-3.79(...W(l1 Mailing Address: ei(.7(� a (. //' ^ � d/A tJ e� �" 1 tate Zip Code Contractor:7-• kirk) i• • h..) Licen^ #: �,L//y' ,] Phone#: p Mailing Address: ',9• /�� 9/ D� O f7- ?Z / C� 7/City State Zip Code DESCRIPTION OF WORK #OF UNITS X COST = TOTAL 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 = LAVS/BASINS,BAR,FLOOR,KITCHEN, 5 SINKS LAUNDRY,UTILITY,JANITOR,PHOTO, X $6.00 = 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,CONDENSATE X $6.00 = ROOF DRAINS/OVERFLOW 12 DRAINS X $6.00 = 13 FOUNTAINS, DRINKING X $6.00 = WATER PIPING/DRAIN-IN WASTE, NSTALLATION ON,REPAIR, i 14 VENT,PLUMBING,REVERSAL REVERSALS / X $6.00 = /p. - 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = ICE AN/OR COFFEE MAKER,HOSE BIB, 16 WATER USING DEVICE STEAMER X $6.00 = PROOFER,CARBONATOR,SWAMP COOLER VACUUM BREAKER,CHECK VALVE, 17 CROSS CONNECTION DEVICE AND R.P.B.P.D.FOR: VATS,TANKS,BOILERS X $6.00 = GREASE TRAP,SAND TRAP, 18 INTERCEPTORS CHEMICAL HOLDING TANK X $6.00 = 19 MEDICAL GAS(per outlet) NITROUS,OXYGEN X $6.00 = • MISCELLANEOUS PLUMBING 20 FIXTUREX $6.00 = 21 PRIVATE SEWAGE DISPOSAUSYS X $20.00 = INDUSTRIAL WASTE 22 INTERCEPTOR X_ $15.00 = SUBTOTAL METHOD OF PAYMENT: PROCESSING FEE ❑ CASH 0 CHECK 0 VISA 0 MASTERCARD $35.00 /� DATE: EXPIRES: TOTAL PERMIT FEE DUE: %/. �/ () BANKCARD NUMBER: AUTHORIZED SIGNATURE: