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2003, 11-20 Permit App: BLD-03-03117 Plumbing Fixtures
crr4< /011 , 11707 East Sprague'Avenue,Suite 106 509-688-0036 Phone N)oRane Spokane Valley,WA 99206 509-688-0037-Fax .00 Valley ., 1 Plumbing Permit Application PROJECT PERMIT • ADDRESS: y/411/1 g , 2 V 1k USE: OWNER: /�/VD g_€ w ..-r }VLA S L PHONE(Daytime Contact): 70/ 3792 MAILING ADDRESS: /` / C-i i i za 3;y dot,' 6uic 4 k ��Litor G1yq i q2 / 1z (street) (city/state) (ZIP) CONTRACTOR: LICENSE#: MAILING ADDRESS: PHONE#: (street) (city/state) (LIP) PLUMBING 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 LAVSBASINS,BAR,FLOOR,KITCHEN, LAUNDRY,UTILITY,JANITOR,PHOTO,X- X $6 = RAY,FOOD;PREP/CULINARY/MEAT 6 DISHWASHER i X $6 = 7 CLOTHES WASHER J X $6 - 8 GARBAGE DISPOSAL X $6 - 9 WATER SOFTENER X $6 - 10 ELECT.HOT WATER TANK NOTE:IF GAS,SEE MECHANICAL firiffe, X $6 - 11 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE 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 X $6 - RP.B.P.D.FOR:VATS,TANKS,BOILERS 17 SPRINKLER SYSTEM X $25 - 18 INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL HOLDING TANK X $6 = 19 MEDICAL GAS per outlet NITROUS,OXYGEN X $6 - 20 MISC.PLUMBING FIXTURE X $6 - SUBTOTAL: IETHOD OF PAYMENT • • i'G'asl- t, PLUS PROCESSING FEE: $35.00 j CASH d CHECK 0 IMENEIN 0 _. -..,':-.L.4-:._ - TOTAL PERMIT FEE DUE: ATE: EXPIRES: ANKCARD NUMBER: UTHORIZED SIGNATURE: