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2003, Permit App: BD-03-778 Plumbing Fixtures
/V 4lirC rrrr,y 11707 East Sprague Avenue,Suite 106 509-688-$136-Phone ' kane Spokane Valley,WA 99206 509-688437-Fax *Valley For Inspections, call 509-688-0054 Plumbing Permit Application i3 V f;5-7 7Si PROJECT PERMIT ADDRESS: -732-7 e loth USE: OWNER: PHONE(Daytime Contact): 62-1471.1.k.- V - -" - MAILING ADDRESS: 73-i' / /i'& /mac jiaL,fi'h c4,,4 *72-1-7-- (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: PHONE#: `2 5 7- 5'05�(3 --31.,)'2.1l ii i i y lqeL vat,/40-,F 6,---(12>'Z (street) / (citystate) (ZIP) • PLUMBING FIXTURES DESCRIPTION DETAILS #OF UNITS X COST EQUALS AMOUNT 1 TOILETS WATER CLOSET,BIDETS { X $6 - b. . 2 URINALS X $6 - 3 TUBS X $6 - 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I X $6 / CO• 5 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 - RAY,FOOD,PREP/CULINARY/MEAT f / " 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 - 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 R.P.B.P.D.FOR:VATS,TANKS,BOILERS X •. 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X - 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: .*THOD OF PAYMENT /uLJC, VISA' Alas PLUS PROCESSING FEE: $35.00 CASH ❑ CHECK ❑ RENNii ❑ '_ ., -_ : TOTAL PERMIT FEE DUE: 55 Tx) C TE: EXPIRES: > NKCARD NUMBER: S 0 L. S /G r(-7 4- 7 1' 3 THORIZED SIGNATURE: �/ / ^. ,_//� , -7 I �7{, j