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1989, 06-30 Permit App: 89002014 Sink PLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: S. CITY/STATE/ZIP: S ,poKG._LA. PARCEL NUMBER: a ��� --�ao3 OWNER: (----49/s Nerevt 1 u-.V . / PHONE NUMBER: ?a 7 - ;>56`i MAILING ADDRESS: S. 5-0,5- Ile_✓c(ev G2_d • 772/6 (Street) (City/StatA)te CONTRACTOR: S+avt(p�/ L'vt ✓/�✓`iS „, li�.c, LICENSE NUMBER: STA/IHi '� /aS4.Z LG PHONE NUMBER: g..Z -S6 7� MAILING ADDRESS: -Z--; 3 DO S y✓a_a u,e_ ,4ve. 6 S,O/54 e_., (1JI4 ?72D6 (Street) (City/State) (Zip) PLUMBING WORKSHEET/FEE SCHEDULE NUMBER OF X EACH DESCRIPTION FIXTURES FIXTURE = AMOUNT TOILETS x $6. 00 = SINKS / x 6. 00 = 4,50 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 x 6. 00 = UTILITY SINKS x 6. 00 = ELECTRIC WATER HEATERS x 6. 00 = FLOOR DRAINS 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 = SUBTOTAL `a ,co PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 31.60 I t I SIGNATURE Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675