2001, 08-27 Permit App: 01007283 Sink r L i(S-V--1 .c) , PLUMBING PERMIT APPLICATION 10( 79- ,I
PROJECT
OWNER:pit{ 11.1)1 IL. 51 / ,A123Nnn` ,h els,d,V PHONE (Daytime Contact):
ASAIL2� ADDRESS:
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(Street) (Cuy/State) (Zip) _
CONTRACTOR 0 w NM •
LICENSE:
MAILING ADDRESS: . 1 PHONE: bog-
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S- It3 Leio.vD `7 "I
L,I ge tt4-Y t-A tc . - l)- 1O let _
(Street) (City/State) am)
PLUMBING FIXTURES I .
#OF n'1' COST/ AMOUNT
DESCRIPTION DETAIL UNITS sr UNIT EQUALS L
i B02 TOILETS 'WATER CLOSETS,BIDETS x 56 -x Se I
B03 URINALS -
B04 TUBS ' BATH.STALL.ON-SITE BUILD z j 56 SO - I
803 SHOWERS ersol x 806 1 SINKS LAVS/BASINS,BAR.F x 56
KITCHEN,LAL'NDR
JANITOR.PHOTO,X-RAY,FOOD
(PREP/CULINARY/MEAT
807 DISHWASHER x 56
B08 CLOTHES WASHER - x -
So
309 GARBAGE DISPOSAL/GRINDER x 56 -
x S6 -
310 WATER SOFTENER (NOTE: if gas rater tank see
nsechanin!)
311 ELECTRIC HOT WATER TANKS CARL A.CASE.COIL,TRENCH, x 56 -
CONDENSATE
312 FLOOR DRAINS • x SO -
B13 ROOF DRAINS/OVERFLOW DRAINS = S6
(ea.) x 56
314 FOUNTAINS.DRINKING -INSTALLATION,
_ x 56
315 WATER PIPING/DRAIN-IN WASTE- REPAIR.RETIOVERN.AS ALTERATION, 56
VP—NT/PLUMBING REVERSALS REPA .R.SUMP PUMP
B16 SEWAGE EJECTORS x S6 -
B17 WATER USING DEVICES ICE AND/OR COFFEE MAKER,
HOSE BIB.STEAMER,PROOFER.
CARBONATOR.SWAMP COOLERS
Bib CROSS CONNECTION DEVICES VACUUM BREAKER CHECK SoVALVE,AND R.P.32.D.FOR:
VATS,SUMPS.TANKS,BOILERS,&
SPRINKLER SYSTEMS 'EASE TRAP,SAND AP, il x 56
-
CHEMI1319 INTERCEPTORS GRTR
CAL HOLDING TANK
x S6
B20 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN I
' S6 J - i
B21 MISCELLANEOUS FLKTIIRES .
SUBTOTAL
METHOD OF PAYMENT
illitel :I1alJ1f PLUS PROCESSING FEE S 25.00
❑ CASH ❑ CHECK ❑ ® 0 ❑ ---
FAXED
F. rERmasMAMA C C� PAYMENT
OFA TOTAL PERMIT FEE DUE
EXPIRES. MINIMUM PERMIT FEE IS$35.00
DATE: PLEASE MASE CHECKS PAYABLE TO
SPOKANE COUNTY PERMIT CENTER
BA!vKCARD NUMBER:
AUTHORIZED SIGNATURE:
a.a Spokane County Division of Building&Planning
.,ic, 1026 West Broadway Avenue'Spokane,WA 992604950
Telephone No.(509)477-3675.Fax No. 324.3193*TDD No. (509)324-3166