Loading...
2003, Permit App: 03-048 Plumbing Fixtures dTti aF Swine ,,,,,,s0Valley 1ley . R 03-- oy�c PLUMBING PERMIT APPLICATION PROJECT PERMIT ADDRESS:' Naris 1Liaiiii 7yoCI C )0SE: OWNER: PHONE(Daytime Contact): MAILING ADDRESS: /5-3 Q b Y (street) Ve RAd zl,s (city/state) U '3, . (zip)LI 90 37 CONTRACTOR: LI ENSE#: D, Ci c&k. .,\{NQ., 0,0 o LAM.C.* l S t K1 MAILING ADDRESS: PHONE#: so CI (iXy _E L( Ss 1 818' E. 8p r G _e.0 e,fLot 'tea_ 49016 (street) (city/state) (zip) PLUMING 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, X $6 KITCHEN,LAUNDRY,UTILITY, 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 $6 = 13 WATER PIPING/DRAIN-IN INSTALLATION,ALTERATION, V X $6 - ©� WASTE,VENT, REPAIR,REVERSALS 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 FIXTURE X $6 = SUBTOTAL MUM Z to 00 ❑ CASH 0 CHECK 0 . 0 a__ PLUS PROCESSING FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT $35.00 OF A MAJOR CREDIT CARD FEE TOTAL PERMIT FEE DUE LI I.00 DATE: EXPIRES: • BANKCARD NUMBER: AUTHORIZED SIGNATURE: .r• f^0 D