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1994, 04-26 Permit App: 94003585 Cross Connect Device
PLUMBING PERMIT APPLICATION q4- 3,85 PROJECT ADDRESS: OWNER: 1.Iti4 C>,q c- t/ MAILING ADDRESS: 9%49- F /`la k w e1 / (street) CONTRACTOR: Spokane ProCare, Inc PIIONE: 9a --g —J/i 9 leo-4 L)c 9?,1-0 (city/state) (zip) LICENSE: SPOKAPI093M6 MAILING ADDRESS: 2823 N Perry PHONE: 483-5249 Spokane Wa 99207 (street) (city/state) (zip) SIGNATURE: WASTER \PLUMFERMHND 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 BO2 TOILETS WATER CLOSETS. BIDETS X $6 = $ BO3 URINALS — x $6 = $ B04 11J135 BATH, JACUZZI, SPA. GARDEN X $6 = $ B05 SHOWERS (per trap) BASE, STALL, ON—SITE BUILD X $6 = $ B06 SINKS IAVSBASINS, BAR, FLOOR, KITCHEN, LAUNDRY, UTILITY, JANITOR. PHOTO, X—RAY, FOOD (PREP/CULINARY/MEAT) x $6 = $ B07 DISHWASHER - x $6 = $ BOS CLOTHES WASHER - x $6 = $ B09 GARBAGE DISPOSAL/GRINDER - x $6 = $ 1310 WATER SOFTENER - x $6 = $ B11 ELECTRIC HOT WATER TANKS (NOTE: if gas water lank, see mechanical) X $6 = $ B12 FLOOR DRAINS AREA, CASE. COIL, TRENCH. CONDENSATE X $6 = $ B13 ROOF DRAINS/OVERFL.OW DRAINS (ea.) - x $6 = $ 1314 FOUNTAINS, DRINKING - x $6 = $ 1115 INSTALLATION, ALTERATION OR REPAIR x $6 = $ WATER PIPING/DRAIN-WAS I h -VENT B16 SEWAGE EJECTORS GRINDER. SUMP PUMP X $6 = $ 1117 WATER USING DEVICES ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER, PROOPER. CARBONATOR. SWAMP COOLERS X $6 = $ 1118 CROSS—CONNECTION DEVICES VACUUM BREAKER, CHECK VALVE, AND R.P.B.P.D. FOR: VATS, SUMPS, TANKS, BOILERS. & SPRINKLER SYSTEMS 1 X $6 = $ 6.00 B19INIERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6 = $ B20 MEDICAL GAS (per outlet/bottle station) NITROUS, OXYGEN X $6 = $ B21 MISCELLANEOUS FIXTURES x $6 = $ NOTE: MINIMUM PERM) FEE IS $35.00 I ) Subtotal 6.00 PLUS: PROCESSING FEE $25.00 TOTAL PERMIT FEE DUE $ 35.00 SIGNATURE: WASTER \PLUMFERMHND SPOKANE COUNTY DIVISION OF BUILDINGS WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 • (509) 456-3675