2005, 01-07 Permit App 05000075 Plumbing Reversal.rHOD O
S�bXkan �'`
,;oOVa11ey
11707 East Sprague Avenue, Suite 106 509-688-0036 - Phone
Spokane Valley, WA 99206 509 -688 -0037 -Fax
For IKgpections, call 509-688-0054
Plumbing Permit Application
PROJECT
ADDRESS: 5
DESCRIPTION
DETAILS
PERMIT
USE:
OWNER
COST
EQUALS
PHONE (Daytime Contact):
MAILING ADDRESS:
TOR.EB
WATER CLOSET, BIDETS
(street)
(city/state)
(ZIP)
CONTRACTOR #
_' J
-h O
2
4
- oeiz
MAILING ADDRESS:
//6J7
cLICENSEI:
PHONE 1:
c 'nom &0
(street)
(city/state)
(ZIP)'
PLUMBING FIXTURES
F
DESCRIPTION
DETAILS
0 OF UNITS
X
COST
EQUALS
AMOUNT
1
TOR.EB
WATER CLOSET, BIDETS
X
$6
2
URINALS
X
$6
"
3
TUBS
X
$6
4
SHOWERS(PER TRAP)
BATH,STAL40N-SITE BUILT
X
$6
5
SINKS
LAVE/BASINS, BAR FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO, X-
RAY, FOOD, PREP/CUL INARY/MEAT
X
$6
6
DISHWASHER
X
$6
"
7
CLOTHES WASHER
x
$6
"
8
GARBAGE DISPOSAL
X
$6
"
9
WATERSOFTENER
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
S6
"
13
WATER PIPING/DRAIN-IN
WASTE, VENT, PLUMBING.
REVERSAL
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
X
$6
(�
14
SEWAGE EJECTOR
GRINDER SUMP PUMP
X
$6
15
WATER USING DEVICE
HOSE B,
ICE AND/OR COFFEE MAKER B
STEAMER, PROOFER, CARBONATOR,
SWAMP COOLER
X
$6
-
16
CROSS CONNECTION DEVICE
VACUUM BREAKER, CHECK VALVE, AND
AP.B.P.D. FOR VATS, TANKS, BOILERS
X
$6
17
SPRINKLER SYSTEM
x
$25
"
IS
INTERCEPTORS
GREASE TRAP, SAND TRAP, CHEMICAL
HOLDING TANK
X
$6
19
MEDICAL GAS per outlet
NTTROUS,OXYGEN
X
S6
20
MISC PLUMBING FIXTURE
x
"
PAYMENT
,.
❑ CHECK ❑ JIMMM ❑ =-
SUBTOTAL:
PLUS PROCESSING FEE:
$35.00
TOTAL PERMIT FEE DUE:
d/
TE:
NKCARD NUMBER
THORIZED SIGNATURE:
EXPIRES
. `� � I'.,3FFi'.GSZ-Od134 Fas 5�3-682-7
i
7 -¢-m
Permit # PW-�
Anticipated start data
ROW CopjS TRUcTION PERMIT
Locat6on of
ApPlicant NaanP of �cto
contractoes
conuactoes
or
�'.. . 1:1,�.: Y
r�Z
Sewer
Ln- Curb & Gwlar . Gas .;Y.:
H r.:r
paveazwg CUT?
1"
FeasFaldb €7X Pjjcatlon3tinopecuonj nnitwill be
In udd e{on to th®' per[nIt aeon fee of X16.00 or $2
inspacUon on oath Pe
Mudd #`? n t e'PO ltWOst a � of $50.00 pr hour vMh a $25.00 (112 l ana n mum. PemiltWo
signawso on Pett wnstituloa sn gnt to tf eee iflnrk3
work complOtOd saWfa lily (SIgno3)._.---
-ees _...acs A-.» d"+YE lti..>eiGLn®d4a:r. TickaS44 Aatexed ;'are