1993, 11-10 Permit App: 93010950 Sewer 1-12A, X31, q '1o950
PLUMBING PERMIT APPLICATION D
PROJECT ADDRESS: S - 3 9 \ Z S u_.).�c\-OLA ,1 � �q - Q L
OWNER: "" --1 ce_ t)J 0 1--I PHONE: (a. - c q c/
MAILING ADDRESS: S t- • ..Lez..�,.._ e'
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(street) (city/state) (zip)
CONTRACTOR: - rn 9T9j 1.7 EC_C_ - LICENSE: -TTPYY1 are_ C U ( 1 C.411L
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PHONE: t 2--6'-7 7 L )
MAILING ADDRESS: 1 L L Z knA 40ti � _,E) F a e A
(street) (city/state) (zip)
PLUMBING FIXTURES #OF mum- COSI'
DESCRIPTION I • DETAIL UNITS MED BY /UNIT EQUALS AMOUNT
TOILETS WATER CLOSETS,BIDETS x $6 = $
URINALS - x $6 = $
was BATH,JACUZZI,SPA,GARDEN x $6 = $
B05 SHOWERS(per trap) BASE,STALL,ON-SITE BUILD x $6 = $
goo SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, X $6 = $
LAUNDRY,UTILITY,JANITOR,PHOTO,
X-RAY,FOOD(PREP/CULINARY/MEAT) ,
WI DISHWASHER - x $6 = $
i.I CLOTHES WASHER - x $6 = $
BO GARBAGE DISPOSAL/GRINDER - x $6 = $
IQ WATER SOFTENER - x $6 = $
iiii ELECTRIC HOT WATER TANKS (NOTE: if gas water tank,see mechanical) x $6 = $
WAFLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE x $6 = $
fib ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $
BI4 FOUNTAINS,DRINKING - x $6 = $
WATER PIPING/DRAIN-WAS1b-VENT INSTALLATION,ALTERATION OR REPAIR X $6 = $
,B16 SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $
On WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
`Sr''igiffi HOSE BIB,STEAMER,PROOPER,
iii:::ii:::i CARBONATOR,SWAMP COOLERS
o CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $
aiiiin AND R.P.B.P.D.FOR:VATS,SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS
+BI9INTERCEPTORS GREASE TRAP,SAND TRAP, X $6 = $
CHEMICAL HOLDING TANK
04 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $
Bl1 MISCELLANEOUS FIXTURES N4 fl,A 14,4,fl, , x $6 = $
Subtotal
NOTE: MINIMUM PERMIT FEE IS$35.00 PLUS: PROCESSING FEE $25.00
r) TOTAL PERMIT FEE DUE $
A
SIGNATURE: �� A -
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SPO COUNTY DIVISION OF BUILDINGS
WEST 1026 BRO AY AVENUE•SPOKANE,WA 99260*(509)456-3675
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