1996, 02-15 Permit App: 96000732 Plumbing Fixtures-3 a PLUMBING PERMIT APPLICATION
PROJECT ADDRESS: j/ O S / 1 L-<)-/ SL
OWNER:
MAILING ADDRESS:
CONTRACTOR:
//off A/ /So ()
street)
S,/Rpf>y
I
MAILING ADDRESS: P(3, 337 )(
PHONE: DAYTIME CONTACT yG 7- R i7'49
S -of .t,41 y /,_J 4
(city/stat(zip)
/l 6:3 (street)
LICENSE: j()/f P Pe n S s L v
PHONE: 4Y7-89'2-'?
(city/state)
TOILETS
PLUMBING FIXTURES
DESCRIPTION 1 DETAIL
WATER CLOSETS. BIDETS
UN°TS
MULTI-
LIED
ULhc® a
x
COST
/UNITI EQUALS
$6
(zip)
AMOUNT
$ (,n -r7
URINALS
x
$6
$
TUBS
BATH, JACUZZI, SPA, GARDEN
x
$6
$
SHOWERS (per trap)
SINKS
BASE, STALL, ON-SITE BUILD
x
$6
n�
IAVS/BASINS, BAR. FLOOR, IUTCHEN,
LAUNDRY, UTILITY, JANITOR PHOTO,
X-RAY, FOOD (PREP/CULINARY/MEAT)
x
$6
6. no
DISHWASHER
x
$6
$
CLOTHES WASHER
x
$6
$
GARBAGE DISPOSAL/GRINDER
x
$6
$
WATER SOFTENER
x
$6
$
ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank, eee mechanical)
x
$6
$
FLOOR DRAINS
AREA, CASE, COIL, TRENCH, CONDENSATE
x
$6
$
ROOF DRAINS/OVERFLOW DRAINS (ea
FOUNTAINS, DRINKING
x
$6
$
x
$6
$
WATER PIPING/DRAIN-WASTE-VENT/
PLUMBING REVERSALS
INSTALLATION, ALTERATION, REPAIR,
REVERSALS
x
$6
$
B
SEWAGE EJECTORS
GRINDER, SUMP PUMP
x
$6
$
WATER USING DEVICES
ICE AND/OR COI'rr.0 MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLERS
x
$6
$
CROSS -CONNECTION DEVICES
VACUUM BREAKER, CHECK VALVE,
AND RP.B.P.D. FOR: VATS, SUMPS,
TANKS, BOILERS, & SPRINKLER SYSTEMS
x
$6
$
INTERCEPTORS
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
x
$6
$
B7`4
MEDICAL GAS (per outlet/bottle station)
MISCELLANEOUS FIXTURES
NITROUS, OXYGEN
x
$6
$
x
$6
$
NOTE: UM 'ERMIT FEE IS $35.00
SIGNATURL
Subtotal
I e oo
PLUS: PROCESSING FEE
$25 .00
TOTAL PERMIT FEE DUE
$ `-1' .13 o0
Spokane County Division of Building & Planning
1026 W. Bradwa
y Avenue
Spokane, ,
WA 99260
* 324-3166
.................................................... .
Tel. No. (509) 456-3675Fax No. (509) 324-3198 TDD No. (509)
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
71610 W41pl+prm.rd