Loading...
2004, 05-13 Permit App: BLD-04-04344 Plumbing Reversal, Fixtures nTt oe ; wk • po .ne >R • Valley - PLUMBING PERMIT APPLICATION PROJECT / J: I \-1-0...,_... PERMIT ADDRESS: lJ J C USE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: (street) (city/state) (zip) CONTRACTOR:C.O v,� 2.\-Ne. t� LICENSE t.a tc * 1 S! P.,1 MAILING ADDRESS: PHONE#: 5o7 ` a-4 -E 1-1 g 19-C3 IS' g, se ua- G-Rp_e-r R-e-c 'ia_ 990 16 (street) (city/state) (zip) PLUMBING FIXTURES DESCRIPTION DETAILS • #OF UNITS X COST EQUALS - AMOUNT 1 TOILETS • WATER CLOSET,BIDETS t X $6 = 2 URINALS • X $6 = 3 TUBS X $6 = 4 SHOWERS(PER TRAP) BATH,STALL,ON-SITE BUILT I , X $6 = • 5 SINKS LAVS/BASINS,BAR,FLOOR, X $6 KITCHEN,LAUNDRY,UTILITY, I JANITOR,PHOTO,X-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 ELEC HOT WATER TANK NOTE:IF GAS SEE MECHANICAL X $6 = 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH, $6 CONDENSATE X 12 FOUNTAINS,DRINKING X $61 = 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION, X $6 WASTE,VENT, REPAIR,REVERSALS I PLUMBING REVERSAL = 14 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6 = 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, X $6 HOSE BIB,STEAMER,PROOFER, CARBONATOR,SWAMP COOLER 16 CROSS CONNECTION VACUUM BREAKER,CHECK X $6 DEVICE VALVE,AND R.P.B.P.D.FOR: VATS,SUMPS,TANKS,BOILERS = 17 SPRINKLER SYSTEM X $25 18 INTERCEPTORS GREASE TRAP,SAND TRAP, $6 • CHEMICAL HOLDING TANK X = 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 = 20 MISC PLUMBING FIXTUREX $6 = - - SUBTOTAL 1 visit - it.f 0 CASH p CHECK 0 IRMIIIR 0 —_._.1 PLUS PROCESSING FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT $35.00 OF A MAJOR CREDIT CARD FEE - TOTAL PERMIT FEE • DUE DATE: EXPIRES: . BANKCARD NUMBER: AUTHORIZED SIGNATURE: