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1990, 09-28 Permit App: 90004991 Remodel, Plumbing Fixtures
Spokane.iCaunty DEPARTMENT OF BUILDING & SAFETY West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 INFORMATION WORKSHEET PARCEL NUMBER: /6 332 _ Z/0 / STREET ADDRESS: ,4, //Zc5 /?oo,o2_ 4v,£ CITY/STATE/ZIP: Sic e,-9-4/.1_ 6.0 •09 9s2O 6 ' `78J -c) SUBDIVISION: /c O6i,(/So,u D/vi (i oA) BLOCK: 1 LOT: ( ZONE: DISTRICT: LOT AREA: F/A: WIDTH: DEPTH: R/W: _SZj # OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: Xk,r,i,g,U efl4io.2J PHONE: J-0 V - 922 - 77 6 MAILING ADDRESS: C_ ,/205 Soo<U, /4/%4 CITY/STATE/ZIP: S eo iV4 95.006- 9/p rj CONTACT: /l/il/�� FF77,/[.f0.(/ oft ['API. Utle aONE: -oS - 9 z z - /7 s6 SETBACKS: - FRONT: LEFT: RIGHT: REAR: PERMIT USE: **************************************************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: MAILING ADDRESS: PHONE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGTi STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL: PLUMBING PERMITAPPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: MAILING ADDRESS: PARCEL NUMBER: PHONE NUMBER: (Street), (City/State) (Zip) CONTRACTOR: • ; ' ,LICENSE NUMBER: ; PHONE NUMBER: ,ri. MAILING ADDRESS:' • ; • e -;(Street) A, (City/State) (Zip) SIM -tx:- .se • :0E; FLOOING„WORKSHEET/FEE,SCHEDULE NUMBER OF EACH FIXTURES=] FIXTURE •=•/-AMOUNT 1°• , ittwftv y.' 4:TOILETS,' SINK iSHOWERS43 13ATHATUBS4,05 ICITCHENA,STNXS: 14:1JISHAWAsHERSl4., ='==GARBAGEi;}DISPOSA tOTHES,1141A.S:HERS' 4LiTILITY)iSINKS:4p;,A ELECTRICWATER4:11EATE FLOOR DRAINS :-- .4 .-..—.4.7.1..-: .1:h'.:,„,,-,:-s"l':,[':'.'7.*3'. • .6 1•C1 - ;•;1,. •3, r0•91. WSINKS'.l kK,iliWNliri.)tv R3i0311kE..- c ;IfgI. :I•." : 'vrl 1,.AWN=APRINKLER,,,, ; ek' sP ! 7 9*.,A7-.7,g0!3: - -= thAtEW:1:SOFTENER. DRINKING FOUNTAIN x;.= =6.00= x. 6:00 = x 6.00 = x 6.00,= • • SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 ° f EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT'FESIS:$35.00m--- - -Tr:FEE DUE , SIGNATURE = Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675