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1991, 05-08 Permit App: 91002434 Lawn SprinklerJOB STREET ADDRESS: PLUMBING ?EMIT APIA...1400N TION FORM InformationWorksheet 1/83 J / Z07 L /14,H;0 CITY/STATE/ZIP: 3pocnNc 99106, PARCEL NUMBER: 9r , c73` OWNER: ICS %lA/Mflt MAILING ADDRESS: /j6/ZVSDS/}Luc (Street) PHONE NUMBER: 772/C (City/State) (Zip) CONTRACTOR: /l/.t& Z�i�rcti�� C� v vc LICENSE NUMBER: /l/mi ZL Ly406 PHONE NUMBER: 9,2Z-3.392 MAILING ADDRESS: ///ii% S giis/n/04ee/ (Street) (City/State) (Zip) NOTE: PLUMBING WORKSHEET/FEE SCHEDULE DESCRIPTION NUMBER OF FIXTURES X EACH FIXTURE = AMOUNT TOILETS SINKS SHOWERS BATH TUBS KITCHEN SINKS DISH WASHERS GARBAGE DISPOSAL CLOTHES WASHER UTILITY SINKS ELECTRIC WATER HEATERS FLOOR DRAINS FLOOR SINKS BAR SINKS ROOF DRAINS LAWN SPRINKLER SEWAGE EJECTOR WATER SOFTENER URINAL DRINKING FOUNTAIN x $6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = r. A_00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = x 6.00 = / 6,4./.2 MINIMUM PERMIT FEE IS $35.00 SUBTOTAL $ 6, ac PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $,js— SIGNATURE West 1303kBroadway AvenuertSpokane, Building_ Safety 456-3675