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1995, 04-03 Permit App: 95001974 Plumbing Fixtures
PLUMBING PERMIT APPLICATION iq 7{ PROJECT ADDRESS: ( (p 0-5 , �, � (t vt OWNER: U /b€/ Oa ..0 PHONE:DAYTIME CONTACT MAILING ADDRESS: (street) (city/state) (zip) CONTRACTOR: LICENSE: PHONE: MAILING ADDRESS: (street) (city/state) (zip) PLUMBING FIXTURES #OF 'burn- COST DESCRIPTION DETAIL UNITS PLED BY /UNIT auuwr.s AMOUNT B02 TOILETS WATER CLOSETS,BIDETS I x $6 = $ B03 URINALS - x $6 = $ B04 TUBS BATH,JACUZZI.SPA,GARDEN X $6 = $ B05 SHOWERS(per trap) BASE,STALL,ON—SITE BUILD 1 x $6 = $ B06 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, x $6 = $ LAUNDRY,UTILITY,JANITOR,PHOTO, X—RAY,FOOD(PREP/CULINARY/MEAT) 1307 DISHWASHER - x $6 = $ B08 CLOTHES WASHER - x $6 = $ B09 GARBAGE DISPOSAL/GRINDER - x $6 = $ 810 WATER SOFTENER - x $6 = $ 011 ELECTRIC HOT WATER TANKS (NOTE: if gas water tank,see mechanical) X $6 = $ 812 FLOOR DRAINS AREA,CASE.COIL,TRENCH.CONDENSATE 3 x $6 = $ B18 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $ B14 FOUNTAINS,DRINKING - x $6 = $ B15 WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION,ALTERATION,REPAIR, x $6 = $ PLUMBING REVERSALS REVERSALS B16 SEWAGE EJECTORS GRINDER SUMP PUMP I x $6 = $ B17 WATER USING DEVICES ICE AND/OR COFFEE MAKER, X $6 = $ HOSE BIB,STEAMER PROOFER, CARBONA1DR.SWAMP COOLERS B18 CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $ AND R.P.B.P.D.FOR:VATS,SUMPS, TANKS BOILERS,&SPRINKLER SYSTEMS B19 INTERCEPTORS GREASE TRAP,SAND TRAP, X $6 = $ CHEMICAL HOLDING TANK 1320 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $ B21 MISCELLANEOUS FIXTURES x $6 = $ NOTE: MINIMUM PERMIT FEE IS$35.00 Subtotal PLUS: PROCESSING FEE $25.00 SIGNATURE: TOTAL PERMIT FEE DUE $ PLEASE MAKE CHECKS PAYABLE TO Spokane County Division of Buildings SPOKANE COUNTY PERMIT CENTER 1026 W.Broadway Avenue*Spokane,WA 99260 Tel.No.(509)456-3675 • Fax No. (509)324-3198 •TDD No. (509)324-3166 Spokane County does not discriminate on the basis of disability in the admission to,or treatment or employment in,its programs or activities. 112095\marenplimperaliffid