1996, 02-27 Permit App: 96000947 Bathroom APPLICATION INFORMATION
What is the JOB SITE address? ASSESSOR'S tax parcel number?
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Legal description as it appears on the property deed Q
OWNER or OCCUPANT - Phone
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Mailingaddress City,state Zip
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Who should we contact regarding this r ject?- ,_ • Phone
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What
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1/ What work is being done under this permit?
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Lone Inspector district Property size Right of way width
a) a)
Water district
4-, 4-,
0. a
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Building Building height #of stories
Contractor Dimensions TOTAL SQUARE FOOTAGE
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WA State Contractor license# 'Main floor area •Unfinished basement area
N ON) L
Mailing address '1nd floor areaFinished basement area
Architect/Engineer Garage area Size of decks,etc.
r What is the heat source? What is the cost ofyour ro e
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Manufactured Home Sign
Width: Length: What is the square footage of How high is the sign?
the sign face?
Year: Make:
Installer Contractor
Wa State Contractor license# Wa State Contractor license#
Mailing address Mailing address
RelocationFire Safety
Previous address Fire Sprinkler _ Tent _
Paint booth_ Fire Alarm Fireworks display
VALUE
Contractor Contractor
WA State Contractor license# WA State Contractor license#
Mailing address Mailing address
•
Fuel Storage Tanks Swimming Pool
(Circle one) Above-ground Underground Size/gallons Private
Contents of tank(s) Size/gallons
Public/semi-private
Contractor Contractor
Wa State Contractor license# WA State Contractor license#
Mailing address Mailing address
COMPLETE ALL APPLICABLE INFORMATION
Spokane County does not discriminate on the basis of disability in the admission to, or treatment or employment in, its programs or activities.
PLUMBING PERMIT APPLICATION
PROJECT ADDRESS: /,2V,)-0 L- �o i2 ))V.( & e
OWNER: ( f r ) *J( // t` / PHONE:DAYTIME CONTACT � y &xi s6
MAILING ADDRESS: C: • /-) t-/d-C L /-0//1(1 h V �c d lC 6� . Cu It CCl
(street) (city state) (zip)
CONTRACTOR: LICENSE:
PHONE:
MAILING ADDRESS:
(street) (city/state) (zip)
PLUMBING FIXIURES #OF MULTI- COST
DESCRIPTION DETAIL UNITS LIED s /UNIT EQUALS AMOUNT
B02 TOILETS WATER CLOSETS,BIDETS / x $6 = $
B03<URINALS - x $6 = $
B04.:TUBS BATH,JACUZZI,SPA,GARDEN X $6 = $
B()5 SHOWERS (per trap) BASE,STALL,ON-SITE BUILD / X $6 = $
Bch SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, X $6 = $
LAUNDRY,UTILITY,JANITOR,PHOTO,
X-RAY,FOOD(PREP/CULINARY/MEAT)
BM DISHWASHER - x $6 = $
B08 CLOTHES WASHER - x $6 = $
BOcY GARBAGE DISPOSAL/GRINDER - x $6 = $
BIB' WATER SOFTENER - x $6 = $
BIT ELECTRIC HOT WATER TANKS (NOTE: if pa water tank,see mechanical) x $6 = $
BI2 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 = $
B1>3>ROOF DRAINS/OVERFLOW DRAINS (ea - x $6 = $
Blit FOUNTAINS, DRINKING - x $6 = $
BJ WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION,ALTERATION,REPAIR, x $6 = $
MR PLUMBING REVERSALS REVERSALS
B16 SEWAGE EJECTORS GRINDER,SUMP PUMP / x $6 = $
B7 WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
HOSE BIB,STEAMER,PROOFER,
CARBONATOR,SWAMP COOLERS
B1$`CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $
AND R.P.B.P.D.FOR VATS,SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS
BI..9 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6 = $
A<'`•`: CHEMICAL HOLDING TANK
B20.>MEDICAL GAS (per outlet/bottle station) NITROUS,OXYGEN x $6 = $
B MISCELLANEOUS FIXTURES x $6 = $
NOTE: MINIMUM PERMIT FEE IS $35.000 Subtotal
PLUS: PROCESSING FEE $25.00
SIGNATURE: TOTAL PERMIT FEE DUE $
MLEASEMAIMPfEcgSTAYABLETCPAN
Spokane County Division of Building&PlanningS. E COUNFY,;PER NTE
1026 W. Broadway Avenue k
e ue S aneWA 99260
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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