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1993, 07-01 Permit App: 93005376 Cross Connect Device
LI�°°a� STAFr�ter �8S PLUMBING PERMIT APPLICATION 93S3'740 (o55a PROJEcrADDRESs: 00II E MISS)0N OWNER: Kt011"-) d- 3€,A- i,••r5£o-JOJZ MAILING ADDRESS: PHONE: A.< (street) (city/state) CONTRACTOR: %eV? Pv (q 'm nC" (zip) MAILING ADDRESS: f --18-t9-3 4- Q VV,-/ (street) LICENSE: SPO KAPT09 3 m 6 PHONE: Ltd 3- 5-9-`49 (city/state) 99x0 7 (zip) SIGNATURE: VAASRRAPWMPER MI IND !CANE COUNTY DIVISION OF BUILDINGS WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 • (509) 456-3675 PLUMBING FIXTURES DESCRIPTION DETAIL # OF UNITS_eum MULTI— By COST _/UNIT EQUALS AMOUNT B02 TOILETS WATER CLOSETS, BIDETS x $6 = $ B03 URINALS - x $6 = $ BO4 TUBS BATH, JACUZZI, SPA. GARDEN x $6 = $ B05 SHOWERS (per trap) BASE, STALL ON—SITE BUILD x $6 = $ B06 SINKS ' LAVSBASINS, BAR. FLOOR, KITCHEN. LAUNDRY. UTILITY. JANITOR, PHOTO, X—RAY. FOOD(PREP/CULINARY/MEAT) 1 x $6 / = $ 1307 DISHWASHER - 1 x / $6 = $ 808 CIATHES WASHER - x f $6 = $ 1309 GARBAGE DISPOSAL/GRINDER - x ! $6 = $ MO WATER SOFTENER - x $6 = $ 1311 ELECTRIC HOT WATER TANKS (NOTE: B bas water mak, see methinks!) X $6 = $ B12 FLOOR DRAINS AREA, CASE. COIL. TRENCH, CONDENSATE x $6 = $ B13 ROOF DRAINS/OVERFLOW DRAINS (ea) - x $6 = $ B14 FOUNTAINS, DRINKING - x $6 = $ B15 WATER PIPING/DRAIN-WASTE-VENT INSTALLATION,ALTERATION OR REPAIR x $6 = $ 1316 SEWAGE EJECTORS GRINDER, SUMP PUMP X $6 = $ 1317 WATER USING DEVICES ICE AND/OR COFFEE MAKER, HOSE BIB, STEAMER. PROOFER, CARBONATOR, SWAMP COOLERS X $6 = $ 1318 CROSS -CONNECTION DEVICES VACUUM BREAKER, CHECK VALVE. AND R.P.B.P.D. FOR: VATS, SUMPS. TANKS, BOILERS, & SPRINKLER SYSTEMS I x $6 = $ % � — b 1319 INTERCEPTORS GREASE TRAP, SAND TRAP, CHEMICAL HOLDING TANK X $6 = $ B20 MEDICAL GAS (per outlet/bottle station) NITROUS. OXYGEN X $6 = $ B21 MISCELLANEOUS FDCFURES x $6 = $ NOTE: MINIMUM PE,RM,�T Flo IS $35.00 /// Subtotal °� PLUS: PROCESSING FEE $25.00 TOTAL PERMIT FEE DUE $ 3S c2S SIGNATURE: VAASRRAPWMPER MI IND !CANE COUNTY DIVISION OF BUILDINGS WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 • (509) 456-3675