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2004, 10-18 Permit App: BLD-04-07945 Plumbing Reversal
• PLUMBING PERMIT APPLICATION Sfioorkia# City of Spokane Valley Community Development Department // BulfdngDivision 40,0ESS�", (�rh , 4 4707 E.Sprague Avenue, Suite 406 1 �e r Spokane Valley, WA 99206 Phone: (509)688-0036;Fax: (509) 688-0037 FOR INSPECTIONS, CALL(509) 688-0054 Project Address: / ( / /l ,4c.' Permit Use: Owner: /(9 Phone (Daytime Contact): • Mailing Address: 5,7in-e City State Zip Code Contractor: 5 /,�,, License#: 7<« / 'Z Phone#: r5-6- -3Y8?Mailing Address: ?ire-76, • CityP e ��'© 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 TUBS X $6.00 . = 4 SHOWERS(PER TRAP) BATH,STALL,ONSITE BUILT X $6.00 = • 5 SINKS LAVSIBASINS,BAR,FLOOR, KITCHEN,LAUNDRY,UTILITY, X $6.00 = JANITOR,PHOTO,X-RAY,FOOD, PREP/CULINARYIMEAT 6 DISHWASHER X $6.00 = 7 CLOTHES WASHER X $6.00 = 8 GARBAGE DISPOSAL X $6.00 = 9 WATER SOFTENER $6.00 = 10 ELECTRIC HOT WATER TANK NOTE IF GAS;SEE MECHANICAL $6.00 = 11 FLOOR DRAINS AREA,CASE,COIL TRENCH, X $6.00 = CONDENSATE 12 ROOF DRAINS/OVERFLOW DRAINS X 36.00 = 13 FOUNTAINS,DRINKING X $6.00 = 14 WATER PIPING/DRAIN-IN WASTE, INSTALLATION,ALTERATION, / X $6.00 = //� VENT, PLUMBING,REVERSAL REPAIR,REVERSALS C� 6"C) 15 SEWAGE EJECTOR GRINDER,SUMP PUMP X $6.00 = 16 WATER USING DEVICE ICE AN/OR COFFEE MAKER, HOSE BIB,STEAMER,PROOFER, X 56.00 = 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 ❑ CHECK 0 VISA ❑ MASTERCARD PROCESSINGFEE $35.00 DATE. EXPIRES: TOTAL PERMIT FEE DUE: 4r V,doO BANKCARD NUMBER: AUTHORIZED SIGNATURE: