1990, 06-25 Permit App: 90002932 Plumbing Fixtures PLUMBING PERMIT APiALICATION FORM
Information Worksheet
JOB STREET ADDRESS: air, ,J -/j/ //6. /�/�5,4.no v c„2. c-. L L
CITY/STATE/ZIP: Dk=.vrr/L j p//;5V• 9yz4gARCEL NUMBER:
OWNER: .5*3J /Z, „42=4- L/-C PHONE NUMBER: �,� J- Y1,2_7
MAILING ADDRESS: //61/3 // -�'' : 4yy 6 )i4 if -e/
(Street) (Cit—y/St'ate) J(Zip)
CONTRACTOR: "�h/ G�yeS J � P4c%+7c�i•�dy
,ICENSE NUMBER: I e ) P /Z(7 _
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
,
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
TOILETS - x $6.00 =
SINKS D x 6. 00 =
SHOWERS x 6.00 =
BATH TUBS x 6.00 =
KITCHEN SINKS x 6.00 =
DISH WASHERS x 6.00 =
GARBAGE DISPOSAL x 6.00 =
CLOTHES WASHER a x 6.00
UTILITY SINKS x 6.00 =
ELECTRIC WATER HEATERS x 6.00 =
FLOOR DRAINS a x 6.00 =
FLOOR SINKS x 6.00 =
BAR SINKS x 6. 00 =
ROOF DRAINS x 6.00 =
LAWN SPRINKLER x 6. 00 =
SEWAGE EJECTOR x 6. 00 =
WATER SOFTENER x 6. 00 =
URINAL x 6. 00 =
DRINKING FOUNTAIN x 6.00 =
I
SUBTOTAL $
PLUS: PROCESSING FEE + $ 25. 00
1
' EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE 1= $
I 1
SIGNATURE !-i 2%_(,
Spokane County Department of Building and Safety
est 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675