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2004, 02-10 Permit App BLD-04-03531 Plumbing FixturesSpokane .000Valley PLUMBING PERMIT APPLICATION PROJECT (''[ ADDRESS* 77Q ij rocd.,NnJ PERMIT USE: OWNER: R 0 id m el P ( PHONE (Daytime Contact): MAILING ADDRESS: Sa-ids._ 'C._ S o , n. e- ()On On _ q J(r, (street) (city/sta e) (zip) CONTRACTOR: I-f 4,3 (:©,J sr;Rt-Lc n J� LICENSE #: N S C n IJ I a s K� MAILING ADDRESS: um g. oaltt ywoy .SpoKane_, PHONE#: qa�— 896� Wa. G19o2o� (street) (city/state) (zip) PLUMRING' FIXTURES DESCRIPTION DETAILS #asairs X COST• EQUALS AMOUNT 1 TOILETS ' WATER CLOSET, BIDETS - j X $6 = 40_ 00 2 URINALS X $6 = 3 TUBS X $6 // 4 SHOWERS (PER TRAP) BATH, STALL, ON -SITE BUILT [ X se = In -D 0 5 SINKS LAVS/BASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X-RAY, FOOD, PREP/CULINARY/MEAT i X $6 = 6, O o 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, CONDENSATE X $6 12 FOUNTAINS, DRINKING X $6 = 13 WATER PIPING/DRAIN-IN WASTE, VENT, PLUMBING REVERSAL INSTALLATION, ALTERATION, REPAIR, REVERSALS 1 X $6 = 6 _ O D 14 GRINDER, SUMP PUMP X $6 = SEWAGE EJECTOR 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOFER, CARBONATOR, SWAMP COOLER X $6 _ 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, SUMPS, TANKS, BOILERS X $6 = 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. aG .— ❑ : `' PLUS PROCESSING FEE $35.00 • CASH 0 CHECK ❑ FAXED PERMITS WILL ONLY BE ACCEPTED WflN PAYMENT OF A MAJOR CREDIT CARD TOTAL PERMIT FEE DUE 5 G. e DATE: EJflES: BANKCARD NUMBER: AUTHORIZED SIGNATURE: