1989, 05-16 Permit App: 89001315 Water Heater PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /\12/ U ( S 7"/el
CITY/STATE/ZIP: - PARCEL NUMBER: (77siJtt - 4Y/'2
14owASE
OWNER: 6 i-1-7 B D y tJ PHONE NUMBER: 1 Z C 5/ 73
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: BANNER FURNACE AND FUEL, INC. LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 53 S_1 7 1 1
MAILING ADDRESS: PO BOX 4346 SPOKANE, WASHINGTON 99202
(Street) (City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
TOILETS x $4.00 =
SINKS x 4.00 =
SHOWERS x 4.00 =
BATH TUBS x 4.00 =
KITCHEN SINKS x 4.00 =
DISH WASHERS x 4.00 =
GARBAGE DISPOSAL x 4 .00 =
CLOTHES WASHER x 4.00 =
UTILITY SINKS x 4.00 =
ELECTRIC WATER HEATERS ( x - 4.00 = L( -bo
FLOOR DRAINS x 4.00 =
FLOOR SINKS x 4.00 =
BAR SINKS x 4.00 =
ROOF DRAINS x 4 .00 =
LAWN SPRINKLER x 4.00 =
SEWAGE EJECTOR x 4.00 =
WATER SOFTENER x 4.00 =
URINAL x 4 .00 =
DRINKING FOUNTAIN x 4.00 =
SUBTOTAL $
PLUS: PROCESSING FEE + $ 15.00
1
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $20.00 FEE DUE I= $ a o,pa
Signature___2 917 d
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane. WA 99260 (Sn4f d5R_3R7S