1995, 08-21 Permit App: 95006512 ToiletPLUMBING PERMITc APPLICATION
PROJECT ADDRESS:
OWNER:
PHONE: DAYTIME CONTACT
MAILING ADDRESS:
CONTRACTOR: cao\je/,, - ji-MA5
(street) (city/state)
MAILING ADDRESS: I 1520 O (_44n
(street)
(zip)
LICENSE:.Q4g F' O \ p (p(r, CJ A
PHONE: G 2r( - GI Lr) R
C�rocnar res WA Gcto) b
(city/state) (zip)
Tel. No. (509) 456-3675 • Fax No. (509) 324-3198 • TDD No. (509) 324-3166
Spokane County does not discriminate on the basis of disability in the admission to. or treatment or employment in. its programs or activities.
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PLUMBING FIXTURES
DESCRIPTION
DETAIL
# OP
UNITS
Tann-
mom air
COST
/UNIT
patina
AMOU�PI'
B02 TOILETS
WATER CLOSETS, BIDETS
x
$6
= $
B03 URINALS
-
x
$6
= S
$04 TUBS
BATH JACUZZI SPA. GARDEN
X
S6
= $
B05 SHOWERS (per trap)
BASESTALL, ON—SITE BUILD
x
$6
= $
806 SINKS
IAVS/BASINS BAR, FLOOR, KITCHEN,
LAUNDRY. UTILITY. JANITOR. PHOTO.
X—RAY, FOOD (PREP/CULINARY/MEAT)
x
$6
= S
1307 DISHWASHER •
- -
x
'S6
. = .S.". .,
BOB CLOTHES WASHER
-
x
$6
= $
809 GARBAGE DISPOSAL/GRINDER
-
_ .
x
$6
= S. !
B10 WATER SOFTENER-
x
$6
= $
B11 ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank see mechanical) - '
x
S6
= . $ '
B12 FLOOR DRAINS
AREA, CASE, WTI. TRENCH, CONDENSATE
x
S6
= S
B13 ROOF DRAINS/OVERFLOW DRAINS (ea.)
-
x
$6
= S
B14 FOUNTAINS, DRINKING
-
x
$6
= S
BIS WATER PIPING/DRAIN-WASTE-VENT/
" PLUMBING REVERSALS -
INSFAUATION ALTERATION. REPAIR
REVERSALS
X
$6
= $
BI6 SEWAGE EJECTORS
GRINDER SUMP PUMP
x
$6
_' $
B17 WATER USING DEVICES
ICE AND/OR COFFEEMAKER.
HOSEBB. STEAMER PROOFER
CARBONATOR, SWAMP COOLERS
x .
$6
= S
'
BIB CROSS -CONNECTION DEVICES
VACUUM BRTAKER.CLECK VALVE,
AND R.P.BPA FOR: VATS SUMPS,
TANKS. BOILERS @ SPRINKLER SYSTEMS
x
S6
= .S
E19INTERCEPTORS
GREASE TRAP, SAND TRAP.
CHEMICAL HOMING TANK
X
$6
= S
$20 MEDICAL GAS (per outletbottle station)
NTTRODs, OXYGEN
X
$6
= $
1121 MISCELLANEOUS FIXTURES
x
$6
= S
Spokane
1026
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE:
Subtotal
PLUS: PROCESSING FEE $25.00
TOTAL PERMIT FEE DUE S
County Division of Buildings
W. Broadway Avenue • Spokane, WA 99260
PLEASE MAICE'CHECKS PAYABLE -TO
SPOKANE COUNTY PERMITCENTER
Tel. No. (509) 456-3675 • Fax No. (509) 324-3198 • TDD No. (509) 324-3166
Spokane County does not discriminate on the basis of disability in the admission to. or treatment or employment in. its programs or activities.
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Dry Line
Sewer? (Ypi
SEWER CONNECTION PERMIT
APPLICATION FORM
PLEASE NOTE: This application form must be filled out accurately and in its entirety, and signed, or a permit
will not be issued. Also note that sewer permits are valid for 12 months from the date of issuance. No
extensions will be granted.
Job address:
City:
Zip:
Parcel number&kno.n):
PROJECT INFORMATION
Owner's name:
Stat' e�2F/
City/State:
Zip:
Phone:
9; 6 -) Yr2
First-time contractors or home -owners performing the installation must first contact the utilities department (in person
or via phone [456-3604]) before a permit can be issued.
Name of Utilities Division person contacted:
CONTRACTOR INFORMATION
Contractor (company name):
A'rnS-M-tqr-\ Cnnsirur-hc>n
Business address: J
Pp Rte 14262
City/State: cp c q*11 vJA
Zip: GGt21 Phone: QZR• ocSa
State contractor license number:
A� M' rt 1.61 l N 1
Utilities installers permit number:
INTERIOR PLUMBING ALTERATIONS? (yes/no) ciroteone
Fill out the information in the table below if applicable**
Contractor (if different from above):
cgcnv o('f- Aown501,
Business Address:
1r1520 ((74h
Phone: q 2`) - c 0 ccR
City/State/Zip:
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vern
Foriplumbint ealfee°lnfonnatidii seneveitideiophrsforn.
Wim'>.+.�.xv,.2.[i�,�.�:'•`'..;'vii'.w�::Cv"J.'.4?5casf.'es�a,.`:;�.:Y-�.�:r.T..4 �c�hr�,+r�}.�'Nr:-:tis �.n:�.zd�•�,'.��w'�:k� ..
FEE INFORMATION
Sewer Connection: Number of Buildings X (times) $SO (per bldg) = $
TOTAL FEE
• One permit required for each separate building, shop, garage, etc., that will be connected to the sewer.
• Condos, townhouses, & 2- 3- and 4plexes require 1 permit per address/stub.
* Multiple buildings (apartments, industrial complexes) require 1 permit per building.
(For situations not covered here, call the County Utilities Division @ 456-3604).
APPLICANT SIGNATURE:
S
Spokane County Division of Buildings
West 1026 Broadway Avenue * Spokane, Washington 99260
PHONE: (509) 456-3675 * FAX: (509) 324-3198 * TDD: (509) 324-3166
Spokane County does not discriminate an the basis of disability In the admission to, or treatment or employment in, Its programs or activities.
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