1994, 08-17 Permit App: 94007982 Plumbing FixturesPLUMBING PERMIT APPLICATION
PROJECT ADDRESS: 76,23 5� (/„///1JA2
(6,11.31
OWNER: 42,X ( 9G CAft5f 5-14 /171-/
MAILING ADDRESS:
PHONE: �ag �O 43
CONTRACTOR:
(street)
l,L - e - GoALc-/-
(city/state)
(zip)
LICENSE:
MAILING ADDRESS: (3 i/ / 4.7"7"-i) — c
(street)
PHONE: 9�7^
(city/stater
9qa/ .
(zip)
SIGNATURE:
SPOKANE COUNTY DIVISION OF BUILDINGS
WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 * (509) 456-3675
PLUMBING FIXTURES
DESCRIPTION DETAIL
# OF
UNITS
MULTI-
PLIED BY
COST
/UNIT
EQUALS
AMOUNT
02 TOILETS
WATER CLOSETS, BIDETS
t/
X
$6
=
$ 6 , or,
URINALS
-
x
$6
=
$
1<i1l'# TUBS
BATH, JACUZZI, SPA, GARDEN
X
$6
=
$
A:i •ii
SHOWERS (per trap)
BASE, STALL, ON-SITE BUILD
X
$6
=
$
SINKS
LAVSBASINS, BAR, FLOOR, KITCHEN,
LAUNDRY, UTILITY, JANITOR, PHOTO,
X-RAY, FOOD (PREP/CULINARY/MEAT)
/
(
X
$6
=
$
/
v ' 0 d
DISHWASHER
-
, �.
x
$6
=
$
CLOTHES WASHER
-
. ".. ' •
x
$6
=
$
GARBAGE DISPOSAL/GRINDER
-
x
$6
=
$
10 WATER SOFTENER
-
x
$6
=
$
1 ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank, see mechanical)
x
$6
=
$
11.111 W
FLOOR DRAINS
AREA, CASE, COIL TRENCH, CONDENSATE
X
$6
=
$
BS ROOF DRAINS/OVERFLOW DRAINS (ea.)
-
x
$6
=
$
Ott FOUNTAINS, DRINKING
-
x
$6
=
$
B WATER PIPING/DRAIN- WASrE-VENT
INSTALLATION, ALTERATION OR REPAIR
X
$6
=
$
[3:6 SEWAGE EJECTORS
GRINDER, SUMP PUMP
X
$6
=
$
1„'1
B WATER USING DEVICES
ICE AND/OR COFFEE MAKER,
HOSE BIB, STEAMER, PROOFER,
CARBONATOR, SWAMP COOLERS
x
$6
=
$
F CROSS -CONNECTION DEVIC'FS
VACUUM BREAKER, CHECK VALVE,
AND R.P.B.P.D. FOR: VATS, SUMPS,
TANKS, BOILERS, & SPRINKLER SYSTEMS
x
$6
=
$
INTERCEPTORS
``•'' F
GREASE TRAP, SAND TRAP,
CHEMICAL HOLDING TANK
x
$6
=
$
MEDICAL GAS (per outlet/bottle station)
NITROUS, OXYGEN •
X
$6
=
$
Eat MISCELLANEOUS FIXTURES
x
$6
=
$
NOTE: MINIMUM PERMIT FEE IS $35.00
Subtotal
la_
PLUS: PROCESSING FEE
$ 25.00
TOTAL PERMIT FEE DUE
$ SI
SIGNATURE:
SPOKANE COUNTY DIVISION OF BUILDINGS
WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 * (509) 456-3675
SEWER CONNECTION PERMIT APPLICATION FORM
*THIS APPLICATION FORM MUST BE FILLED OUT ACCURATELY AND IN ITS ENTIRETY AND
SIGNED OR PERMIT WILL NOT BE ISSUED.
(IF KNOWN)
JOB ADDRESS: PARCEL NUMBER:
CITY: STATE: ZIP CODE:
OWNER NAME: ADDRESS:
CITY: STATE: ZIP CODE:
PHONE NUMBER:
PROPERTY OWNER PERFORMING SEWER CONNECTION INSTALLATION? YES NO
(CIRCLE ONE)
*IF PROPERTY OWNER INSTALLING SEWER THEY MUST FIRST CONTACT THE UTILITIES
DEPARTMENT FOR CONSTRUCTION REQUIREMENTS BEFORE PERMIT IS ISSUED.
CONTRACTOR:1L„C, Cp nS+rt -± r,n
ADDRESS: 13 I lc, . 12)41
CITY: S nnKn !\ v. STATE: .v.JA-
1
PHONE NUMBER: 92,1 - ,� (r,n
STATE CONTRACTORS LICENSE NUMBER: i L✓ G C C -A- �- 10 1 M /,-,
ZIP CODE: CI
UTILITIES INSTALLERS PERNIZT,NUMBER:
INTERIOR PLUMBING ALTERATIONS? YES NO (CIRCLE ONE)
INTERIOR ALTERATION BY:
ADDRESS:
CITY: STATE: ZIP CODE:
PHONE NUMBER:
*ONE PERMIT REQUIRED FOR EACH SEPARATE BUILDING, SHOP, GARAGE, ETC. THAT WILL
BE CONNECTED TO THE SEWER.
SEWER CONNECTION •# OF BUILDINGS X 50.00 =
INTERIOR PLUMBING ALTERATIONS:# OF BUILDINGS X 35.00 =
TOTAL PERMIT FEE DUE $
APPLICANT
SIGNATURE:
DATE:
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
WEST 1026 BROADWAY AVENUE, SPOKANE, WA. 99260 (509) 456-3675