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2003, 11-03 Permit App BLD-03-02964 Plumbing Reversal
ETHOD OF CASH LTE: aTlc• .<\'' 40,0 *`Valley Plumbing Permit Application 11707 East Sprague Avenue, Suite 106 509-688-0036 Phone Spokane Valley, WA 99206 509-688-0037 - Fax PROJECT n• ADDRFSS: ' G,L 9' 0 L� /-`� ,� PERMIT USE: OWNER: 4---- ,e lc,( 2. pay k `G-7i PHONE (Daytime Contact): MAILING ADDRESS: f Li G S Lc/1 J% `/ (street) • (ci state) • (ZIP) CONTRACTOR LICENSE #: MAILING ADDRESS: S,-t E es- 4" 46 1--"-C- - PHONE #: (street) (city/state) (ZIP). • . PLUMBING FIXTURE DESCRIPTION _ DETAILS # OF UNTTS X COST EQUALS AMOUNT 1 TOILETS - WATER CLOSET, BIDETS X - $6 2 URINALS X 86 - 3 TUBS X 86 - 4 SHOWERS (PER TRAP) BATH, STALL, ON -SITE BUILT X $6 5 SINKS ' LAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR, PHOTO, X- RAY, FOOD; PREP/CULINARY/MEAT X • ' 86 - 6 DISHWASHER X 86 - 7 CLOTHES WASHER X • $6 - • 8 GARBAGE DISPOSAL X $6 - 9 WATER SOFTENER X 86 - 10 ELECT. HOT WA rt,X TANK NOTE: IF GAS, SEE MECHANICAL X $6 - 11 FLOOR DRAINS AREA, CASE, COIL, TRENCH, CONDENSATE X $6 . - 12 FOUNTAINS, DRINKNG _... _- ----_-----._----.___-- 13 WATER PIPING/DRAIN-IN INSTALLATION, ALTERATION, REPAIR, WASTE, PLUMBING REVERSALS • 1.VENT X 86 - (en S!� 14 SEWAGE EJECTOR GRINDER, SUMP PUMP X $6 - 15 WATER USING DEVICE ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, ?ROOFER, CARBONATOR, SWAMP COOLER X $6' • 16 CROSS CONNECTION DEVICE VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, TANKS, BOILERS X - 17 SPRINKLER SYSTEM X 825 - 18 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X 19 MEDICAL GAS per outlet NITROUS, OXYGEN X $6 20 MLSC. PLUMBING FIXTURE X $6 - PAYMENT r_-�........._ • SUBTOTAL: /Cy . f • iiiiiiii CHECK ❑ 0 _ ="^ _ PLUS PROCESSING FEE: - $35.00 • • • fls TOTAL PERMIT FEE DUE: �% / -, NKCARD NUMBER: THORIZED SIGNATURE: